What does a low Anti-Mullerian Hormone (AMH) level indicate?

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From the Guidelines

Low Anti-Müllerian Hormone (AMH) levels typically indicate a lower ovarian reserve, meaning a woman has a reduced number of eggs remaining in her ovaries, which can make it more challenging to conceive naturally 1.

Key Points to Consider

  • AMH levels below 1.0 ng/mL are generally considered low, and levels below 0.5 ng/mL are considered very low 1.
  • In such cases, fertility treatments like In Vitro Fertilization (IVF) or egg donation may be recommended 1.
  • It's essential to consult a fertility specialist for personalized guidance and to discuss potential treatment options, which may include medications like follicle-stimulating hormone (FSH) or gonadotropin-releasing hormone (GnRH) agonists to stimulate egg production 1.
  • The most effective approach will depend on individual circumstances, including age, medical history, and overall health 1.

Important Considerations

  • Age is a critical factor, as AMH levels naturally decline with age, and the interpretation of AMH levels may vary depending on the age of the woman 1.
  • Medical history, including any previous treatments or conditions that may affect ovarian reserve, should be taken into account when interpreting AMH levels and determining the best course of treatment 1.

From the Research

Low Anti-Mullerian Hormone (AMH) Levels

A low AMH level is often associated with a decreased ovarian reserve, which can indicate a lower number of remaining eggs in the ovaries 2, 3, 4. This can be a concern for women who are trying to conceive, as it may affect their ability to get pregnant.

Indications of Low AMH Levels

Some indications of low AMH levels include:

  • Reduced ovarian reserve, which can increase the risk of premature ovarian insufficiency 3
  • Decreased number of antral follicles, which can affect fertility 2, 4
  • Increased risk of poor response to ovarian stimulation, which can impact the success of fertility treatments 5
  • Potential predictor of upcoming menopause, although the accuracy of this prediction can vary 6

Factors That Can Influence AMH Levels

Several factors can influence AMH levels, including:

  • Age, with AMH levels decreasing consecutively from the third decade of life 6
  • Ovarian surgery, which can damage the ovaries and affect AMH production 3
  • Family history of premature ovarian failure, which can increase the risk of low AMH levels 3
  • Endometriosis, which can affect ovarian function and AMH production 3

Clinical Use of AMH Measurements

AMH measurements can be used in clinical settings to:

  • Assess ovarian reserve and predict the risk of poor response to ovarian stimulation 5
  • Guide individualized follicle-stimulating hormone dosing protocols 5
  • Predict the age of natural menopause, although the accuracy of this prediction can vary 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

The role of anti-müllerian hormone (AMH) in assessing ovarian reserve.

The Journal of clinical endocrinology and metabolism, 2011

Research

Review of clinical indicators, including serum anti-Müllerian hormone levels, for identification of women who should consider egg freezing.

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2017

Research

Anti-Müllerian Hormone and Ovarian Reserve: Update on Assessing Ovarian Function.

The Journal of clinical endocrinology and metabolism, 2020

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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