The cells in the ovarian follicles produce an anti-Müllerian hormone (AMH). Typically, higher AMH levels indicate a greater number of eggs. Measuring AMH levels can help a doctor identify fertility issues.
The article below covers typical AMH levels by range compared with what doctors might classify as high and or low levels. We also examine why and how testing occurs, what high and low levels of AMH mean regarding fertility and polycystic ovary syndrome (PCOS), and whether Medicare covers testing.
Females are born with a certain number of eggs. They have about 300,000–500,000 eggs at birth, but this number decreases with age. By about the time of menopause, some females may have only 1,000 eggs left.
Levels based on age
The measurement of AMH is in nanograms per milliliter (ng/mL). Below are
|20–25 years||4.23 ng/mL|
|26–30 years||3.48 ng/mL|
|31–35 years||2.43 ng/mL|
|36–40 years||1.28 ng/mL|
|40–44 years||0.52 ng/mL|
A high level of AMH may mean a person has a high number of eggs available and has a better chance of responding to fertility treatments.
High levels of AMH can also indicate a person has PCOS, which occurs due to an imbalance of hormones.
People with PCOS have an increased number of follicles in the growing stage, which can produce AMH. However, fertility problems can arise due to the inability of these eggs to develop into a dominant follicle and release or ovulate from it.
Doctors may not recommend trying to lower AMH levels. However, a
Low levels of AMH may mean a person has a reduced quantity of eggs. AMH hormone comes from the cells surrounding the egg in the follicle, and as the number of follicles or eggs decreases with time, so does the AMH level. Certain medical conditions and toxic exposures, such as chemotherapy, can also make AMH levels decrease.
The American College of Obstetricians and Gynecologists (ACOG) defines low AMH levels as less than 1 ng/ml.
According to the ACOG, around 15% of couples experience infertility when trying to conceive. Measuring AMH could help doctors determine if low egg count contributes to infertility and, if so, what the possible causes are.
However, a low AMH level does not necessarily mean a female is infertile. It is an indicator of the ovarian reserve, not the ability to become pregnant.
AMH also helps indicate the number of potential eggs a female has. A high level of AMH shows a person may have a high ovarian reserve and many potential eggs left. This may mean they will have a better chance of getting pregnant.
Individuals getting an AMH test do not need to do anything to prepare. Levels of AMH remain stable throughout the menstrual cycle so that the doctor can perform the test on any day or time during the cycle.
Testing AMH at home
Home hormone kits are available to test AMH levels without going to a lab. The testing process requires users to prick their fingers to obtain a blood sample. Various manufacturers offer AMH tests alone or in combination with other hormones.
Healthcare professionals may test AMH levels for various reasons. Doctors may want to determine if the number of eggs a female has is declining. It may also help diagnose certain medical conditions that affect a person’s ovarian reserve.
Doctors may also perform the test to assess possible responses to fertility treatment. According to 2022 research, doctors commonly use AMH measurements to predict ovarian response for females undergoing reproductive treatment.
However, measuring AMH levels does not offer a complete picture of a person’s likelihood of pregnancy.
Insurance coverage for AMH testing varies widely by company. For example, some companies cover diagnostic tests relating to fertility treatments but not the treatments themselves.
As a diagnostic test, some insurance companies cover AMH testing.
Medicare Part B also covers medically necessary diagnostic tests, including blood tests.
Below are some FAQs surrounding the topic.
What are the differences between AMH and FSH?
AMH and follicle-stimulating hormone (FSH) are markers for assessing fertility. FSH stimulates the follicles in the ovaries to grow and develop during the menstrual cycle. The granulose cells, which surround the eggs inside the follicles, produce AMH.
Higher levels of AMH show a higher number of eggs, while lower levels indicate a lower number of eggs.
In comparison, high FSH levels usually indicate a low number of eggs. The brain signals the ovary to produce more FSH if the egg supply becomes low.
How do AMH levels affect the chances of having twins?
Higher AMH levels may indicate a higher chance of having twins. An older study shows that AMH concentrations were 1.4 times higher in females with twins compared with those with one baby.
The cells in the ovarian follicle produce an anti-Müllerian (AMH) hormone. AMH levels indicate ovarian reserve or the number of eggs a female has left.
Doctors measure AMH levels to help determine fertility problems and the likelihood of successful fertility treatments. The higher AMH is, the more eggs a female might have. Lower levels indicate a low number of eggs.