amh guidance guage

Understanding AMH and its Importance

AMH or anti-Mullerian hormone is a hormone that is produced, naturally, in cells of developing ovarian egg sacs or follicles. Evaluating the level of AMH present in a woman’s blood can be very useful in assessing her ovarian reserve. The level of AMH remains relatively constant and therefore can be evaluated at any time during one’s cycle.

Why to evaluate your AMH Level?

AMH is produced in the earliest stages of ovarian follicle development, those less than 8 mm in size.  As a result, evaluation of a woman’s AMH level can be an indicator of the potential egg supply one has; or simply put, an evaluation of the woman’s biological clock time and current ovarian reserve. In general, the higher the levels of AMH, the higher the ovarian reserve and vice versa. It should be noted that AMH only provides an indicator of available ovarian reserve quantity and doesn’t evaluate the quality.

Like your ovarian reserve, AMH levels will decline with age. If one is of younger age and has a low AMH value with regards to her age it could be an early indicator of diminished ovarian reserve. In such circumstances, it is highly advised to seek further evaluation from a reproductive specialist who can verify the AMH levels by completing an ultrasound known as an antral follicle count. If confirmed, then a conversation regarding fertility preservation and other options available can be had.

While an AMH level can be an indicator of one’s ovarian reserve it can also be used to assist in providing a diagnosis of polycystic ovary syndrome (PCOS). PCOS is one of the most common causes of reproductive difficulty.  PCOS is characterized by the presence of a larger number of small ovarian follicles; thus, leading to high AMH levels.

What is a “Normal” AMH Level?

The definition of “normal” ranges for AMH are not yet fully clarified or agreed on by experts due to the relatively young age of utilization as a routine evaluation test. Additionally, commercially available assays do not all provide equivalent results making the definition of “normal” somewhat difficult.

That is why it is better to evaluate one’s AMH level by comparing their age and a percentile bracket. For example, a value of 2.0 ng/mL is about the 50th percentile for a woman age 39 which would be considered “normal”.  While for a woman age 26, that same value of 2.0 ng/mL is only the 10th percentile and is likely an indicator of early onset diminished ovarian reserve (DOR).  Several studies have been completed and the below table shows an AMH guideline with 50th percentile values derived from the available literature to help provide some reference ranges based on age.

Age BracketAMH (ng/mL)
208.0
21-337.0
24-266.0
27-295.0
30-324.0
33-353.5
36-382.5
39-411.5
42-440.7

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