AMH — Anti-Müllerian Hormone

What is AMH?

Anti-Müllerian Hormone (AMH) is a protein hormone produced by the granulosa cells surrounding small, developing follicles in the ovaries. Each follicle contains a developing egg. AMH is secreted continuously by these follicles at a relatively stable level, making it one of the most reliable markers of the total remaining egg supply — known as ovarian reserve.

Unlike other reproductive hormones (such as FSH or oestradiol), AMH does not fluctuate significantly across the menstrual cycle, meaning it can be tested on any day of the month without the need to time the appointment to a specific cycle day. The result reflects the size of the remaining follicle pool, which declines naturally and irreversibly from birth onwards, with acceleration after the late 30s.

AMH is widely used in fertility medicine to assess a woman's likely response to IVF ovarian stimulation, predict the approximate timing of menopause, and help identify conditions such as premature ovarian insufficiency (early menopause) and polycystic ovary syndrome (PCOS). It does not directly measure egg quality — only egg quantity — and a normal AMH does not guarantee fertility.

Normal AMH range (age-dependent)

AMH is highly age-dependent. Unlike most blood tests, there is no single universal reference range — results must always be interpreted relative to age. Approximate guidance:

• Age 25–30: ~14–50 pmol/L (good ovarian reserve)
• Age 30–35: ~10–35 pmol/L
• Age 35–40: ~4–20 pmol/L
• Age 40–45: ~1–10 pmol/L (declining sharply)
• Age 45+: Often <2 pmol/L; approaching menopausal range
• Very high AMH at any age (>50–60 pmol/L): May indicate PCOS

These ranges are approximate guidance only. There is substantial individual variation, and AMH alone cannot confirm or exclude fertility. It must be interpreted alongside clinical assessment.

What a low AMH may indicate

A low AMH relative to age suggests a reduced ovarian reserve — fewer follicles and eggs remaining than expected. Possible causes and implications include:

• Reduced ovarian reserve — the egg supply is at the lower end of normal for the patient's age, which may affect natural conception rates and IVF success
• Premature ovarian insufficiency (POI) — ovarian function declining before the age of 40; may eventually lead to early menopause
• Previous ovarian surgery — removal of an ovarian cyst or ovary reduces the total follicle pool
• Previous chemotherapy or radiotherapy — can damage follicles and permanently lower AMH
• Poor IVF response — a low AMH predicts fewer eggs retrieved during IVF stimulation and may prompt adjustments to the stimulation protocol

What a high AMH may indicate

An AMH significantly above the expected range for age most commonly points to:

• Polycystic ovary syndrome (PCOS) — the most common cause; many small antral follicles in the ovary each contribute to elevated AMH, often producing values 2–3 times above the age-appropriate average
• Risk of ovarian hyperstimulation syndrome (OHSS) — a high AMH predicts an exaggerated response to IVF stimulation, requiring careful protocol adjustment to avoid OHSS
• Naturally high reserve — some women have a larger-than-average follicle pool without any underlying condition
• Granulosa cell tumour — very rare; extremely high AMH in the context of other symptoms may occasionally prompt further investigation

Get your AMH tested at The Vesey

AMH testing is available at The Vesey Private Hospital, Sutton Coldfield, with no fasting required and no need to time to a specific cycle day:

• Fertility Panel AMH — £95 (standalone AMH ovarian reserve test)
• Fertility Panel Standard — AMH combined with FSH, LH, oestradiol, prolactin, and thyroid function for a comprehensive reproductive hormone assessment

No fasting required. AMH can be tested on any day of your menstrual cycle. Results reviewed by a clinician before release, usually within 24–48 hours.

Frequently asked questions

Further reading: AMH — Lab Tests Online UK · Independent patient information from the British Society for Clinical Biochemistry.