You've just received your blood test results and you read "AMH: 0,8 ng/mL". Your heart sinks. You frantically Google "normal AMH level 35 years old" and stumble upon forums discussing "low ovarian reserve", mandatory IVF, and "too late". Stop. Breathe. This number does not define your fertility. It does not predict whether you will get pregnant or not. And above all, it says absolutely nothing about the quality of your eggs.
Anti-Müllerian hormone (AMH) is probably the most misunderstood marker of female fertility. It's made to say things it doesn't say. It's brandished like a verdict. The essential point is forgotten: AMH measures the amount follicles available for future cycles, not their qualitynor your actual chances of pregnancy. Some women with an AMH of 0,3 conceive naturally. Others with a normal AMH experience repeated failures. This article separates fact from fiction, supported by scientific data.
The essentials to understand (before panicking)
AMH: Simple Definition (No Jargon)
Anti-Müllerian hormone (AMH) is a glycoprotein produced by the granulosa cells of ovarian follicles. In simpler terms, it's the tiny follicles in your ovaries (those that contain the developing eggs) that produce this hormone.
Concretely, what is it for?
Imagine your ovaries as a seed bank. Each month, several seeds begin to germinate (the pre-antral and antral follicles), but only one will fully develop into a fertilized egg. AMH is produced by these germinating seeds.
The more follicles you have developing, the more AMH you produce. The fewer you have, the less you produce. As a result, the AMH level in your blood indirectly reflects the number of follicles available in your ovaries for future cycles. This is what is called "ovarian reserve".
But be careful: AMH ≠ Fertility
This is THE trap everyone falls into. The AMH tells you how much follicles are potentially available. She doesn't tell you:
- If your eggs are of good quality
- If you ovulate properly
- If your fallopian tubes are permeable
- If your uterus can accommodate an embryo
- If your partner's sperm is fertile
- Whether you are going to get pregnant or not
💡 Moral A low AMH level means you have fewer follicles in reserve. This can make conception take longer or complicate IVF (fewer eggs can be retrieved). However, it doesn't predict your chances of natural pregnancy if you ovulate regularly and your eggs are of good quality.
Normal AMH Levels: Reference Values by Age
AMH levels naturally decrease with age, as your follicle reserve gradually diminishes. However, there is significant individual variability: two women of the same age can have radically different AMH levels without this causing any problems.
How to Interpret Your AMH Level
⚠️ Important These values are indicative and vary from one laboratory to another depending on the testing technique used. Always check your lab's reference ranges. And above all: a low level is not a death sentence. Your age, ovulation, and the quality of your cycles are much more important.
Why We Measure AMH: The Real Indications
AMH testing is not routine. It has specific indications, mainly in the context of a fertility assessment or assisted reproductive technology (ART).
1. Fertility Assessment (Difficulty Conceiving)
If you are unable to get pregnant after 1 year of trying (or 6 months if you are over 35), your doctor may prescribe an AMH test to assess your ovarian reserve.
The goal : To understand if the difficulty in conceiving comes (among other things) from a diminished ovarian reserve or if the problem lies elsewhere.
2. Before IVF: Predicting the Response to Stimulation
AMH is the most reliable indicator for predicting how many eggs your ovaries will produce after ovarian stimulation. This allows for adjusting medication dosages.
- High AMH → risk of hyperstimulation, reduce doses
- Normal AMH → standard protocol
- Low AMH → increased doses, but few oocytes expected
3. Diagnosis of PCOS (Polycystic Ovary Syndrome)
A very high AMH level (> 5-6 ng/mL) associated with other signs (irregular cycles, hyperandrogenism, polycystic ovaries on ultrasound) may suggest PCOS. AMH is not part of the official diagnostic criteria, but it is a strong indicator.
4. Before Ovarian Surgery or Gonadotoxic Treatment
Before ovarian surgery (endometriosis, cysts) or chemotherapy, AMH testing can assess the impact on your ovarian reserve and potentially offer fertility preservation (oocyte freezing).
How is AMH Tested: Blood Test and Timing
Measuring AMH is simple: a standard blood test. Its main advantage over other hormonal markers (FSH, estradiol) is that it can be done any day of the cycle.
AMH Testing: Which Day of the Cycle?
Short answer: it doesn't matter. Unlike FSH or estradiol, which must be measured between days 2 and 5 of the cycle, AMH varies very little during the menstrual cycle. Therefore, you can have your blood test done at any time.
Nuance : Some laboratories observe a slight peak in AMH in the middle of the cycle (ovulation period), but the difference is minimal (approximately 10-20%) and does not change the overall interpretation.
Preparation and Results
- No special preparation required No need to fast (unless other tests require it)
- Results timeframe 24 to 48 hours in general
- Refund Yes, through Social Security as part of a fertility assessment
- Inter-laboratory variability Assay techniques vary. Always have your tests done in the same lab if possible.
AMH Basse: Can I Get Pregnant Naturally?
This is THE question that haunts all women who receive a low AMH result. The answer is frustrating but true: It depends. And most importantly, yes, it is possible.
What Science Says
A meta-analysis published in Reproductive Biology and Endocrinology (2021) concludes that AMH levels are not a reliable indicator of the chances of spontaneous pregnancy.What really matters: egg quality, hormonal status, and the luteal phase.
A 2022 study from Peking University followed women over 40 with very low AMH levels. The result: they achieved natural pregnancy rates similar to younger women. when they experienced good quality ovulation and a well-structured cycle.
Field testimonies Naturopaths specializing in fertility regularly report natural pregnancies in women with AMH levels of 0,3-0,5, sometimes even at age 42. The key element: restoring a healthy ovulatory cycle.
Very Low AMH and Natural Pregnancy: Documented Cases
Natural pregnancies have been documented with extremely low AMH levels, including:
- AMH at 0,19 ng/mL (39 years old): pregnancy achieved after optimization of the terrain
- AMH at 0,26 ng/mL (35 years old): natural pregnancy after 3 months of targeted support
- AMH at 0,3 ng/mL (42 years old): spontaneous pregnancy after IVF had failed
- Undetectable AMH (presumed menopause): ovulation restarted by hormonal strategy
💡 What makes the difference This isn't about your AMH level. It's about your actual age, the quality of your ovulation, your overall hormonal balance (FSH, LH, progesterone, thyroid), the condition of your endometrium, and your partner's fertility. AMH is just one piece of the puzzle.
Low AMH: Is IVF Necessary?
No. Low AMH complicates IVF (few eggs can be retrieved), but it doesn't make natural pregnancy impossible. It all depends on your overall situation.
Minimum AMH Level for IVF
There is no universal "minimum threshold". Some centers accept IVF with AMH < 0,5 ng/mL, others refuse below 1 ng/mL.
The problem with very low AMH in IVF Few oocytes are retrieved (sometimes 1-2, or even none), resulting in few embryos and decreasing the chances of success. Some teams then prefer to refer patients for egg donation, especially after age 38-40.
Can You Increase Your AMH Levels? The Honest Answer
No, you cannot "restore" your ovarian reserve. You are born with a predetermined stock of follicles (approximately 1-2 million), which inexorably diminishes throughout your life. This process is irreversible.
⚠️ Beware of miraculous promises
No dietary supplement, no plant, no diet can regenerate your primary follicles or sustainably increase your AMH. Any promise to do so is false.
But you can optimize the quality of what remains.
While you can't increase the quantity of eggs, you can improve their quality and create the best conditions for pregnancy. That's what you need to focus on.
Levers for optimizing oocyte quality
- Anti-inflammatory diet Limit refined sugars, favour omega-3 fatty acids and antioxidants (red fruits, green vegetables)
- Targeted supplements CoQ10, folic acid, vitamin D, inositol, NAC (under medical supervision)
- Stress management Chronically elevated cortisol levels impact oocyte quality
- Quality sleep Melatonin, produced at night, protects oocytes from oxidative stress.
- Moderate physical activity Improves ovarian circulation, but not in excess (intense exercise can disrupt ovulation)
- Avoid toxins Tobacco, alcohol, endocrine disruptors (plastics, pesticides)
Factors That Can Minorly Affect AMH
Some studies have shown links between AMH levels and:
- Vitamin D A good blood vitamin D3 level is correlated with a better AMH level
- Solar exposure Seasonality and vitamin D synthesis slightly influence AMH
- Chronic stress Prolonged stress can temporarily decrease AMH levels.
- Contraceptive pill May temporarily decrease AMH (it increases again after stopping)
But be careful: these variations remain modest (10-30% at best) and do not transform a very low AMH into a normal AMH.
AMH and Other Markers: The Complete Assessment of Ovarian Reserve
AMH is never interpreted alone. A complete ovarian reserve assessment includes several additional tests.
💡 Cross-interpretation is essential A low AMH level with normal FSH and a good follicle count is less concerning than a low AMH level with high FSH and a low atrial fibrillation (AFC). Only a doctor can analyze all of this data in your specific context.
Common Misinterpretations of AMH
AMH is poorly understood, even sometimes by some healthcare professionals. Let's set the record straight.
❌ Error 1: "Low AMH = infertile"
False. AMH measures the quantitative reserve, not the ability to conceive. Many natural pregnancies occur with very low AMH if ovulation is of good quality.
❌ Mistake 2: "High AMH = super fertile"
Not necessarily. A very high AMH level may indicate PCOS, with ovulation disorders that reduce fertility despite an abundant reserve.
❌ Mistake 3: "AMH predicts the age of menopause"
Partially true. A very low AMH level may suggest early menopause, but the prediction remains imprecise. AMH becomes undetectable approximately 5 years before menopause.
❌ Error 4: "AMH testing needs to be repeated regularly"
Useless. AMH levels naturally decline with age in a predictable manner. Repeating the test every 6 months offers no benefit, except perhaps additional anxiety.
Taking Care of Yourself During the Journey
Worried about your AMH level? Facing fertility treatment? Take care of yourself. Our period panties will support you every day, with complete peace of mind.
A Number Does Not Define Your Fertility
Anti-Müllerian hormone (AMH) measures the number of growing follicles in your ovaries, reflecting your ovarian reserve. A normal level is between 2 and 5 ng/mL at age 30, and naturally declines with age. Unlike other hormone markers, AMH can be measured on any day of your cycle with a simple blood test.
A low AMH level does NOT mean infertility. It indicates that you have fewer available follicles, which can complicate IVF (fewer eggs can be retrieved), but it doesn't prevent natural pregnancy if you ovulate regularly and your eggs are of good quality. Women with an AMH of 0,3 get pregnant naturally. Age, egg quality, and overall hormonal balance matter far more than a simple AMH number. You can't increase your egg reserve, but you can optimize the quality of your eggs. Stop treating this number as a definitive judgment. Instead, listen to your body, your cycles, and seek guidance from qualified professionals.
Sources & Scientific References
This article is based on validated scientific studies and leading medical journals on anti-Müllerian hormone and ovarian reserve.
Main studies on AMH
- Visser JA, de Jong FH, Laven JS, Themmen AP. (2006). Anti-Müllerian hormone: a new marker for ovarian function. Reproduction. DOI: 10.1530/rep.1.00529
- Dewailly D, Andersen CY, Balen A, et al. (2014). The physiology and clinical utility of anti-Mullerian hormone in women. Human Reproduction Update. DOI: 10.1093/humupd/dmu020
- Broer SL, Broekmans FJ, Laven JS, Fauser BC. (2014). Anti-Müllerian hormone: ovarian reserve testing and its potential clinical implications. Human Reproduction Update. DOI: 10.1093/humupd/dmu020
- Anderson RA, Anckaert E, Bosch E, et al. (2020). Anti-Müllerian Hormone and Ovarian Reserve: Update on Assessing Ovarian Function. The Journal of Clinical Endocrinology & Metabolism. DOI: 10.1210/clinem/dgaa513
- La Marca A, Sighinolfi G, Radi D, et al. (2010). Anti-Müllerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART). Human Reproduction Update. DOI: 10.1093/humupd/dmp036
- Steiner AZ, Pritchard D, Stanczyk FZ, et al. (2017). Association Between Biomarkers of Ovarian Reserve and Infertility Among Older Women of Reproductive Age. JAMA. DOI: 10.1001/jama.2017.14588 – Study demonstrating that low AMH does not predict infertility in women of childbearing age
- Zhang B, Meng Y, Jiang X, et al. (2019). IVF outcomes of women with discrepancies between age and serum anti-Müllerian hormone levels. Reproductive Biology and Endocrinology. DOI: 10.1186/s12958-019-0505-8
Footnotes The DOI links provide direct access to the original scientific publications. This article will be updated regularly to reflect the latest research.
Medical warning This article is for informational purposes only and is not a substitute for professional medical advice. If you have questions about your fertility, ovarian reserve, or the interpretation of your AMH results, consult a gynecologist, endocrinologist, or reproductive medicine specialist.
