Spotlight:

• AMH, which stands for Anti-Mullerian Hormone, is a hormone produced by the ovaries. 
• Because it’s found in and regulates the growth of the same follicles on the ovaries that house the eggs, it is seen as a good indicator of egg count in women.
• AMH is measured using a blood test. As AMH fluctuates throughout the menstrual cycle, you should take a test between day 2-5 when sharing your results with a fertility clinic. 
• AMH also changes with age, so the ‘normal’ range varies for different age groups. There is not a standardised set of parameters, ‘high’, ‘low’ and ‘normal’ ranges vary between clinics, laboratories and countries. 
• Both the NHS and fertility clinics base their eligibility for treatments on AMH levels, and fertility financing providers take this into account too.
• AMH levels are just one indicator when it comes to fertility, it’s a directional measure, not definitive. If you have low or high AMH levels, you could still conceive naturally or with the help of tailored fertility treatment. 

AMH, or Anti-Mullerian Hormone, is a hormone produced by the follicles on the ovaries to regulate their growth and development. These follicles also contain the eggs, and the role of AMH is to ensure that only a certain number of follicles mature and release an egg every menstrual cycle. [1] The general indication is that a higher AMH level means a higher number of follicles and therefore a higher number of potential eggs.

AMH levels are measured with a blood test. This is usually done with either an at-home finger-prick test, which is then sent back to a lab to be analysed. Alternatively, your healthcare provider will take a blood test in-person, before sending the sample for analysis and sharing the results. We can help to arrange an AMH test via our Clinic Matcher or through a third party provider. (We get paid by testing providers, but it won't impact the price you pay. It's how we keep all of our guides and community resources free for everyone to use.)

The NHS, fertility clinics and fertility financing providers all ask for AMH levels when you are initially registering, as it can determine whether you’re eligible for funding or treatment, and help to inform the best plan for you. You can read more about accessing fertility financing in our guide to the cost of IVF, here. As our clinical expert Kayleigh explains:

“The NHS and fertility clinics have an AMH threshold, which they use to determine which patients they will and will not treat, as well as the best plan going forward – so, it’s important to check that your AMH level fits the acceptance criteria for the clinics you’re considering. This is in-built in our Clinic Matcher, to ensure you’ll only be matched with clinics that accept your AMH test result.”

An AMH test is often one of the first tests to do if you’re thinking about conceiving, freezing your eggs or having fertility treatment. As an indicator of egg count (or ovarian reserves), knowing your AMH levels could help you decide on your next steps.

AMH levels can also indicate underlying gynaecological conditions, such as PCOS (read more about PCOS, here) – those with PCOS often have a higher number of follicles on the ovaries, and therefore a higher AMH level. And, as AMH levels decrease with age, an AMH test could help to identify early menopause.

Women (as assigned at birth) are born with all the eggs they will ever have. Unlike other cells in the body, like skin cells, eggs don't regenerate. This means the number and quality of eggs reduces over time. Lower quality eggs often show lower rates of fertilisation and development, and the chance of successful pregnancy using them is also smaller. This is the reason why AMH levels decline with age – as the number of eggs reduces, so does the number of follicles on the ovaries and therefore the amount of AMH produced. AMH levels generally decrease more significantly from the age of 30, and more so in the mid-late thirties through to menopause [3], so the ‘normal’ range varies for different age groups. 

There is not a standardised set of parameters either, ‘normal’ ranges and units of measurement can vary between clinics, labs and countries – so it’s best not to compare results from different places. The below is an average guide provided by the NHS [4]:

High AMH can indicate a high number of eggs and possibly increased fertility, but it can also indicate an underlying issue causing the ovaries to produce too much AMH, such as PCOS. PCOS is a common condition affecting one in 10 women [5], and 19% of our founding community – those who have shared personal details, experiences and clinic reviews that are powering our new approach to fertility treatment. Though it can impact fertility, there are treatments available to help manage the condition and support those who would like to conceive. You can read more about PCOS and fertility in our guide, here. 

Low AMH can indicate fewer eggs (low ovarian reserves) and therefore lower fertility, though it is not a measure of egg quality – and if you’re trying to conceive naturally, one good egg released a month means there’s a fair chance of success. If you’re looking into fertility treatment or egg freezing, low AMH levels will likely influence your treatment path. 

It’s also important to note that this AMH is just one measure, your reproductive health depends on many different factors and is hard to predict based on testing alone. To understand your full fertility picture, a doctor will take into account your medical history, lifestyle factors, age and lots of other criteria; if you have low AMH they will likely run a scan to count the follicles on your ovaries, and take various additional blood tests. Your AMH level is directional, not definitive, ie. it might point you in the right direction of treatment, but it won’t determine your full plan or outcome.

Your next steps entirely depend on your personal circumstances. For example, if you’ve been trying to conceive for a while, if you have low AMH, if you’re over the age of 35, and/or have any underlying conditions, you might want to speak to a fertility clinic to see what options are available to you. You can find out whether you’re eligible for NHS fertility treatment using our calculator, here; it’s also worth bearing in mind that there is a waiting time for those eligible for NHS treatment. 

For more immediate action, our Clinic Matcher can direct you to the best clinics for you. As part of this process, we can also help to arrange an AMH test if you haven’t yet done one (the results will help to determine your personalised clinic shortlist). We work closely with clinics to ensure you won’t have to repeat the AMH test and you can speak to several clinics before deciding which you’d like to proceed with, efficiently managing your time, energy and costs. We are the only place in the UK that facilitates fertility treatment in this way, powered by and for our community.