What AMH actually is
Anti-Müllerian Hormone is produced by granulosa cells in early-stage ovarian follicles. The hormone correlates with the size of the ovarian reserve pool, the number of follicles available to potentially ovulate over your remaining reproductive years.
Higher AMH = larger remaining reserve. Lower AMH = smaller remaining reserve. Near-zero AMH = nearing menopause.
Age-based ranges
| Age | Average AMH (ng/mL) | Optimal range |
|---|---|---|
| 25 | 3.5 | 2.0-6.0 |
| 30 | 2.5 | 1.5-4.5 |
| 35 | 1.8 | 1.0-3.5 |
| 40 | 1.0 | 0.5-2.5 |
| 45 | 0.4 | 0.1-1.5 |
| 50 | 0.1 | ≤0.5 |
What AMH predicts
- IVF response. Higher AMH predicts more eggs retrieved per stimulation cycle. Useful for IVF planning.
- Premature ovarian insufficiency. Very low AMH for age suggests POI; warrants investigation.
- Rough menopause timing. Very low AMH (under 0.2) suggests menopause within ~2 years.
- Fertility window. Suggests how much time the woman has if she wants biological children.
What AMH does not predict
- Whether you can conceive naturally this month. Pregnancy depends on egg quality this cycle, not pool size.
- Egg quality. AMH measures quantity, not quality. Quality declines with age; AMH doesn't capture this.
- Symptoms. Many women with low AMH still have normal cycles and no menopausal symptoms, until they don't.
- How long until pregnancy occurs. Statistical predictions only.
Fertility planning
For women considering delayed parenthood:
- AMH at 30: data point for whether to consider egg freezing
- AMH at 35: more pressing, egg freezing is most cost-effective in early-to-mid 30s
- AMH dropping rapidly: consider sooner
For women trying to conceive: AMH gives some information but the more relevant data is age-adjusted natural fertility rates.
Menopause prediction
The Tehran Lipid and Glucose Study and other longitudinal cohorts have shown AMH predicts menopause timing within ~3-4 years. Useful for women in their 40s wanting to know roughly when to expect the transition. Not precise enough for exact prediction.
When to test
- Any time in cycle (unlike FSH which is best on day 3)
- Even on hormonal birth control (slightly suppressed but still informative)
- As part of comprehensive female hormone panel
- When considering fertility timing
- If perimenopause is suspected
The clinical pearl: AMH is a planning tool, not a fertility prediction. It tells you how much reserve you have left. It doesn't tell you whether your reserve is high quality.
Bottom line
AMH is a useful but commonly misinterpreted lab. It reflects ovarian reserve, the pool of remaining follicles, and helps with fertility planning and rough menopause prediction. It doesn't predict natural fertility this month or egg quality. For women in their 30s and 40s, it's part of a comprehensive female hormone workup.