What is AMH? Anti-Müllerian hormone explained

AMH stands for anti-Müllerian hormone. In women it is made in the ovaries, and the amount in your blood tracks how many eggs you have left. This page explains what the hormone is and what its level can and can’t say. If you want to know how to get tested, see the AMH test page.

AMH

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Where AMH comes from

MedlinePlus explains that in females, the ovaries make AMH, and in males, the testes do. ACOG describes it as produced by the granulosa cells surrounding each oocyte (egg) in a developing ovarian follicle.

Follicles are the small sacs in the ovary that hold immature eggs. AMH is low in girls, and at puberty the follicles begin to make more of it. In healthy women of childbearing age, higher levels mean the ovaries hold a larger supply of eggs.

The name comes from the hormone’s role in a fetus. In a male fetus, AMH makes the Müllerian ducts shrink, which lets male organs develop. A female fetus has very low AMH, so the ducts develop into the uterus, fallopian tubes and upper vagina.

Why AMH falls with age

The number of eggs decreases with age, and AMH decreases with it. MedlinePlus says levels drop to zero at menopause. ACOG says multiple studies have shown that AMH declines across the reproductive lifespan.

A large retrospective study of women at US fertility centers found median AMH fell steadily from age 24 to 50. The median dropped about 0.2 ng/mL a year up to age 35 and about 0.1 ng/mL a year after that (Seifer et al., 2011). Those women were being seen at fertility centers, so they are not a picture of all women. For published numbers by age band, see AMH levels by age.

What AMH is used for

According to MedlinePlus, AMH tests are mainly used with other tests to make decisions about treating female infertility. In that setting the level can help show how large the egg supply is and how the ovaries are likely to respond to fertility medicine.

Clinicians also look at it in other settings:

• Polycystic ovary syndrome (PCOS). A high level can be a sign of PCOS, but MedlinePlus says an AMH test alone cannot diagnose it.
• Menopause. A low level may mean you are getting close to menopause, but MedlinePlus says AMH can’t predict when you will reach it.

What AMH does not tell you

AMH reflects egg quantity, not egg quality. MedlinePlus says an AMH test can tell you the size of your egg supply, but it can’t tell you about the health of your eggs or predict whether you’ll be able to get pregnant.

ACOG goes further for women who have no known fertility problem. It says a single AMH result in a population of women with presumed fertility does not appear to be useful in predicting time to pregnancy. ASRM describes ovarian reserve markers as poor predictors of reproductive potential independently from age.

If you have questions about your own fertility, a clinician can put your age, history and any test results together.

How AMH is measured

AMH is measured in a blood sample. The FDA decision summary for one AMH assay reports results in both ng/mL and pmol/L. A laboratory medicine editorial notes that automated assays yield lower AMH levels than the older ELISA method, so numbers from two labs may not line up. For one published age table and how to read it, go to AMH levels by age.