AMH levels by age: a published table and how to read it

AMH falls with age, so the same number can mean different things at 28 and at 40. Below is one published table of AMH by age band, copied from the source, and a plain guide to what the numbers can and can’t say.

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AMH reference values by age

This table comes from the FDA decision summary for the Access AMH assay (Beckman Coulter, submission K170524). The summary describes a reference range study of 666 apparently healthy females aged 18 to 45, with samples tested at 5 geographically diverse sites. (The age-band counts in its table add up to 620, not 666; the summary does not explain the gap.) The values below are for serum.

The same source lists the values in pmol/L. For serum:

Age (years)	Median (pmol/L)	95% reference interval (pmol/L)
18 to 25	25.70	7.28 to 104.46
26 to 30	27.27	4.93 to 95.60
31 to 35	17.64	2.57 to 71.90
36 to 40	12.21	1.29 to 40.56
41 to 45	3.86	0.07 to 21.35

The source has no rows for ages under 18 or over 45, and we have not added any.

How to read the table

The median is the middle value in that age group: half of the women had a lower level and half a higher one. The 95% reference interval is the range the source reports for the group.

Two things stand out. Medians are highest at ages 26 to 30 and lower in each older band, and the range within any age band is wide. At ages 31 to 35 the interval runs from 0.36 to 10.07 ng/mL, so two healthy women of the same age can have very different levels.

A separate study of 17,120 women at US fertility centers also found AMH falling steadily with age from 24 to 50. Its median fell about 0.2 ng/mL a year to age 35 and 0.1 ng/mL a year after (Seifer et al., 2011).

Why your lab’s numbers may differ

The table above is for one assay. Other assays give other numbers, and your lab’s report will carry its own range.

• A laboratory medicine editorial notes that automated assays yield lower AMH levels than the older ELISA method, that reference intervals should use narrow age bins, and that serum AMH differs between ethnic groups.
• ASRM says cutoffs for AMH vary across studies.

If your result is close to the edge of a range, read it against the range printed on your own report.

What counts as low AMH

There is no single cutoff. Some examples show how much the definitions vary:

• A 2017 JAMA study of women aged 30 to 44 defined low AMH as under 0.7 ng/mL.
• The FDA decision summaries for the Access AMH and Elecsys AMH assays give a clinical cutoff of 1.77 ng/mL, used to separate women with an antral follicle count above 15 from those at 15 or below (Access AMH, Elecsys AMH). That is a statement about follicle counts in women at fertility clinics, not a line between normal and abnormal.

MedlinePlus says a low level means the egg supply is shrinking and you may have difficulty getting pregnant. It also says AMH can’t tell you about the health of your eggs or predict whether you will be able to get pregnant.

What a high AMH can mean

A high level can be a sign of polycystic ovary syndrome (PCOS), but MedlinePlus says an AMH test alone cannot diagnose PCOS. A clinician looks at your symptoms, history and other tests. See PCOS tests for more.

What AMH by age can’t tell you

An age table shows where your result sits compared with other women. It does not show your chance of conceiving.

• ACOG says a single AMH level in women with presumed fertility does not appear to be useful in predicting time to pregnancy.
• ASRM says ovarian reserve markers are poor predictors of reproductive potential independently from age.
• In a study of 750 women aged 30 to 44 with no history of infertility, those with low AMH did not have a significantly different chance of conceiving over 6 or 12 cycles than women with normal AMH.

ASRM also notes that the evidence is not uniform. It cites one cohort of 3,150 women in which AMH under 1 ng/mL was associated with a lower chance of pregnancy, and a meta-analysis in which AMH had poor predictive value for spontaneous pregnancy.

If your result worries you, or you have been trying to conceive for 12 months (6 months if you are 35 or older), a clinician can read it alongside your age and history. To check your own level, see the AMH test.