Point one
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. The general indication is that a higher AMH level means a higher number of follicles and therefore a higher number of potential eggs. [1]
In this guide, we’ll go into more detail about low AMH levels, how the NHS and fertility clinics advise conceiving with low AMH levels. It’s important to note that overall, AMH levels decrease with age and cannot be increased. However, AMH levels are an indication of quantity not quality of eggs, and there are several approaches to improving egg quality, which could have a positive impact on your fertility. We’ll discuss the lifestyle changes that are widely regarded to be helpful later on in this guide.
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.)
Yes, you can ask your GP for an AMH test — but whether it's offered on the NHS can depend on your age, symptoms, and where you live. Some GPs may be able to refer you for testing if you’ve been trying to conceive for a while or have signs of fertility-related conditions. If it’s not available through your GP, you still have the option to arrange a private test, either through a clinic or an at-home provider.
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.
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. You can have your AMH levels tested at any time, since “the range of AMH level remains relatively stable throughout your menstrual cycle”. [6]
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 are also used to predict how you might respond to ovarian stimulation medication, which is prescribed during IVF and egg freezing to help increase the numbers of mature eggs ready for fertilisation or freezing. Knowing your AMH levels helps the clinic decide on the dosage and timings of this medication. [2]
Higher levels of AMH tend to respond better to a lower dose for a shorter period, while lower levels of AMH tend to be treated with a higher dose for a longer period before egg extraction, and might require more cycles in total. Egg donation could also be an option for those with low ovarian reserves.
AMH levels can also indicate underlying gynaecological conditions, such as PCOS (Polycystic Ovary Syndrome) — 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, so the 'normal' range varies for different age groups. [3]
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]:
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 — it might point you in the right direction of treatment, but it won't determine your full plan or outcome.
AMH levels decrease with age and the general consensus is that low AMH levels cannot be increased. However, AMH levels relate to egg quantity, not quality. You could have low AMH levels, but still have high-quality eggs; and conversely, you could have high AMH levels (which is more common in people with PCOS, for example), but lower quality eggs. Given that AMH levels can be affected by underlying conditions like PCOS, treatment of these conditions can also help to improve fertility health.
Whether your test results show low AMH levels or high AMH levels, optimising various aspects of your reproductive health by making some lifestyle changes could be helpful in improving your overall fertility — and these apply to both men and women. Suggestions include, as listed by the NHS:
There’s no strong evidence to show that losing weight directly increases AMH levels — but it can have a positive effect on your overall reproductive health, especially if you’re living with conditions like PCOS. In some studies, weight loss in people with PCOS has been linked to more regular ovulation and improved hormone balance, which might indirectly support fertility, even if AMH levels stay the same or only shift slightly. [7]
It's also worth noting that BMI is one factor clinics often consider when assessing fertility treatment eligibility, so working towards a healthy weight could make a difference in how your body responds to treatment. [8]
Yes — it’s absolutely possible to ovulate regularly even if you have low AMH. AMH reflects the number of eggs you have, not whether or not your body is releasing one each cycle. So if your periods are fairly predictable and you're not skipping cycles, there’s a good chance you're still ovulating.
Seeing a big drop in your AMH can feel worrying — but it’s not always a sign that something is wrong. AMH naturally declines as we get older, and for some, that decline can happen more noticeably or more quickly than expected. This might be linked to age-related changes like menopause, genetics, lifestyle influences, or underlying health conditions. [9]
In some cases, treatments like chemotherapy, certain surgeries, or autoimmune conditions can affect how many follicles your ovaries are able to produce — and that’s what AMH is measuring. Even the test itself can vary slightly between labs, and small differences in how a sample is handled can impact the final result. [10,11,12]
If your AMH level has changed significantly in a short time, it’s worth following up with your doctor. They may suggest retesting, doing an antral follicle count via ultrasound, or running other blood tests to build a fuller, more accurate picture of your fertility health.
No, low AMH doesn’t mean you’re infertile — it means you may have fewer eggs, but it doesn’t speak to your ability to conceive. Many people with low AMH still ovulate regularly, produce healthy eggs, and go on to have successful pregnancies, both naturally and with support. [13]
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, 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. [5]
Not necessarily. A high AMH level tells us there may be a greater number of eggs, but it doesn’t speak to how good those eggs are. Egg quality isn’t something AMH can measure. [14]
That said, some people with very high AMH levels — especially those with PCOS — may have eggs that don’t mature properly or ovulate regularly, which can impact fertility. But it’s not a given. Plenty of people with high AMH go on to conceive without issues.
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 — 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.
There’s no single AMH level that guarantees or rules out the possibility of pregnancy. People conceive at all kinds of levels — both with support and without. While an AMH reading between 1.0–4.0 ng/mL (7.14–28.6 pmol/L) is often considered within the expected range for fertility, it’s just one part of a much broader picture. What truly matters is how everything is working together — including your age, whether you’re ovulating regularly, and the quality of the eggs being released. [4]
So far, there’s no strong evidence that stress directly lowers AMH levels — though stress can influence other hormones that affect your cycle and overall fertility. If you're feeling overwhelmed, it's still worth addressing — not for AMH specifically, but for your well-being and hormonal balance as a whole. [15]
There’s some evidence to suggest that vitamin D may have a small, positive effect on AMH levels — particularly in people who are vitamin D deficient. A few studies have found that supplementing with vitamin D could help regulate AMH production in the ovaries, especially in those with PCOS, though the overall impact is still being researched. If you want to explore whether vitamin D could positively impact your AMH level, consult with your doctor. [16]
Folic acid is essential for reproductive health, but there’s limited evidence to suggest it directly increases AMH levels. One study found a potential association between higher folate intake and slightly higher AMH in women of reproductive age, but the effect was modest and not fully understood. While folic acid is a key part of preconception care, especially for reducing neural tube defects, its role in AMH regulation is still being explored. [17]
There’s limited research directly linking sleep deprivation to AMH levels, but poor sleep can impact overall hormone regulation — including those involved in fertility. One study found a possible association between short sleep duration and lower AMH levels in women, while another suggested that there’s no link between short sleep duration and AMH levels. [18,19]
No, low AMH is not linked to an increased risk of Down syndrome. AMH is a marker of how many eggs you may have left — not the genetic quality of those eggs or the likelihood of chromosomal conditions.
The risk of having a baby with Down syndrome increases with age, and that’s due to changes in egg quality over time, not AMH levels specifically. While AMH naturally declines as we age (just like egg quality does), they are two separate processes. AMH is about quantity; chromosomal abnormalities like Down syndrome relate to quality — and that’s influenced by age more than hormone levels. [20]
Low AMH on its own isn’t known to cause miscarriage. While it reflects the number of eggs you have, it doesn’t directly predict whether a pregnancy will progress or not. The main factors linked to miscarriage risk are age, underlying health conditions, and egg or embryo quality — not AMH levels specifically.
That said, because AMH tends to decline with age, and age is associated with higher chances of chromosomal abnormalities in eggs, low AMH and miscarriage risk can sometimes be seen together — but one doesn’t cause the other. It’s more about correlation than causation. [21]
If miscarriage is a concern, your care team will look at the bigger picture — including your age, medical history, hormone levels, and any past pregnancy experiences — to offer tailored support.
Low AMH itself doesn’t increase the likelihood of having twins. In fact, higher AMH levels — particularly in fertility treatment settings or in people with PCOS — are more commonly linked to multiple egg release and a higher chance of non-identical twins. [22]
However, age can have an influence. From around age 35, it’s more common for the body to release more than one egg in a cycle — a natural process known as follicular recruitment. So if you're in that age group, your age itself may slightly increase the chances of conceiving fraternal twins, regardless of your AMH level. [23]
If you’ve been told you have low AMH and you’re not ready to try for a baby just yet, egg freezing may be worth considering. Lower AMH levels often mean fewer eggs are collected in each cycle, so your clinic may recommend multiple rounds to give you the best possible chance of success later on.
That doesn’t mean it’s not an option — it just means your clinic will likely tailor the approach to your specific situation, and outcomes may vary. AMH gives insight into egg quantity, but not quality, which also plays a crucial role in outcomes. Your age, health background, and personal goals all matter when weighing up whether now is the right time to preserve your fertility.
