What are the chances of pregnancy for a 33-year-old woman with a low Anti-Mullerian Hormone (AMH) level of 0.8?

Pregnancy Chances with AMH 0.8 ng/mL at Age 33

A 33-year-old woman with AMH 0.8 ng/mL has reasonable pregnancy chances through both natural conception and IVF, though she faces a modestly increased miscarriage risk (approximately 28% higher than women with normal AMH) and should pursue fertility evaluation without delay. 1

Understanding Your Ovarian Reserve Status

• Your AMH of 0.8 ng/mL indicates diminished ovarian reserve (DOR), falling just below the 1.0 ng/mL threshold that defines low ovarian reserve 2
• Critical distinction: Low AMH primarily reflects reduced egg quantity, not necessarily reduced pregnancy potential per cycle attempted 3
• At age 33, you remain in a favorable age category where egg quality is generally preserved despite lower quantity 2

Natural Conception Prospects

• Large prospective studies demonstrate that women with AMH <0.7 ng/mL achieve similar cumulative pregnancy rates after 12 cycles of attempting conception compared to women with normal AMH, after adjusting for age 3
• Your AMH of 0.8 ng/mL sits slightly above this threshold, suggesting comparable or potentially better natural fertility outcomes 3
• Time-to-pregnancy may be slightly prolonged, but ultimate pregnancy achievement remains realistic with consistent attempts 3

IVF Success Rates

• Women with low AMH (0.2-1.0 ng/mL) achieve cumulative pregnancy rates of approximately 20% after five IVF cycles, comparable to those with extremely low AMH (<0.2 ng/mL) 4
• Per-cycle ongoing pregnancy rates of approximately 4.4% are reported for low AMH patients, though cumulative success improves substantially with multiple attempts 4
• You will likely retrieve fewer oocytes per cycle (typically 3-5 eggs), but embryo quality and implantation potential remain reasonable at your age 4, 5
• Even women over age 40 with AMH <0.4 ng/mL achieve pregnancies, indicating that extremely low AMH does not preclude success 5

Miscarriage Risk Considerations

Your AMH level confers a modestly elevated miscarriage risk that requires acknowledgment but should not deter pregnancy attempts:

• Women under 35 with low AMH (<1.1 ng/mL) face an odds ratio of 1.28 for miscarriage compared to those with medium AMH levels (95% CI: 1.07-1.53) 1
• This translates to approximately 28% increased relative risk, though absolute risk differences remain modest 1
• The mechanism likely involves higher rates of aneuploid embryos in women with DOR, though your age provides protective benefit 2
• Women with severely low AMH (<0.7 ng/mL) face higher miscarriage risk (OR 1.91), but your level of 0.8 ng/mL falls outside this highest-risk category 1

Important Nuance on Miscarriage Data

• Recent research using euploid (chromosomally normal) embryo transfers shows low AMH independently predicts early pregnancy loss even after excluding chromosomal abnormalities 6
• However, other high-quality studies found no association between low AMH and miscarriage risk when accounting for pregnancy probability through inverse probability weighting 7
• The evidence remains somewhat conflicting, but the preponderance suggests a modest increase in miscarriage risk that should inform counseling without precluding attempts 1, 7, 6

Recommended Action Plan

Pursue fertility evaluation and attempts promptly given your diminished ovarian reserve:

• Obtain baseline FSH and estradiol levels to complement AMH assessment 2
• Monitor menstrual cycle regularity for any signs of premature ovarian insufficiency 2
• Consider earlier referral to reproductive endocrinology (within 6 months of attempting rather than the standard 12 months) given your DOR status 2
• Discuss fertility preservation options (egg or embryo freezing) if you anticipate delaying pregnancy attempts, as AMH will continue declining 2
• Repeat AMH measurement in 6-12 months to establish trajectory, ensuring consistent menstrual cycle timing for accuracy 8

Critical Pitfalls to Avoid

• Do not allow low AMH alone to exclude you from IVF treatment or discourage pregnancy attempts—AMH predicts quantity of eggs retrieved, not per-cycle pregnancy potential 4
• Avoid excessive delay in pursuing fertility, as your ovarian reserve will continue declining and age-related egg quality deterioration accelerates after 35 2
• Do not interpret low AMH as indicating poor egg quality; at age 33, your eggs likely maintain good developmental competence despite reduced numbers 3
• Ensure AMH testing uses consistent assay methodology, as different laboratory platforms yield varying results 2

Bottom Line

Your AMH of 0.8 ng/mL indicates you have fewer eggs remaining but does not preclude successful pregnancy through either natural conception or IVF. The evidence strongly supports pursuing fertility promptly with realistic optimism, understanding you may need multiple IVF cycles if that route becomes necessary, and accepting a modestly elevated but manageable miscarriage risk. Your age of 33 remains your most favorable prognostic factor, outweighing the significance of your diminished ovarian reserve. 3, 4