Understanding AMH Levels and Egg Reserve: What Your Test Results Really Mean
Dr Vrushni Bhuta
MS OBGY, Fellowship in Endoscopy (ICOG), M.R.M (UK) - Fertility Specialist & Gynaecologist
Dr Vrushni's Women's Care & Fertility Clinic, Mumbai
"Doctor, what does my AMH level mean?"
This is one of the most common questions I hear in my fertility clinic in Mumbai.
And it's followed by anxiety, confusion, and sometimes panic — especially when the number is lower than expected.
If you've recently had your AMH (Anti-Mullerian Hormone) tested and you're wondering what it means for your fertility, you're not alone. Many women receive their AMH results without clear context, leading to unnecessary worry or, worse, delayed action when time matters.
Here's the truth:
AMH is not a fertility fortune teller.
It doesn't tell you if you can or cannot get pregnant.
What it does tell you is how many eggs you have left — your ovarian reserve.
In this guide, I'll explain AMH in clear, human terms — what it measures, what normal levels look like at different ages, what low AMH actually means, and most importantly, what you can do about it.
No jargon. No fearmongering. Just honest, evidence-based information to help you make informed decisions about your fertility.
Quick Take: AMH at a Glance
- AMH measures egg quantity, not egg quality
- Low AMH doesn't mean you can't get pregnant naturally
- AMH levels naturally decline with age, especially after 35
- AMH < 1.2 ng/mL indicates diminished ovarian reserve
- Treatment is still possible and often successful with low AMH
What Is AMH (Anti-Mullerian Hormone)?
AMH is a hormone produced by the small follicles in your ovaries — the tiny sacs that contain immature eggs.
The more follicles you have, the higher your AMH level. As you age and your egg supply decreases, so does your AMH.
Think of AMH as a rough estimate of how many eggs remain in your ovarian "bank account."
Why AMH Testing Matters
- Assesses ovarian reserve before fertility treatment
- Helps predict response to IVF stimulation
- Guides treatment planning and medication dosing
- Identifies women who may benefit from egg freezing
- Provides a fertility timeline for women planning to delay pregnancy
Important: AMH can be tested on any day of your menstrual cycle, unlike other fertility hormones. This makes it convenient and reliable for fertility assessment.
At Dr Vrushni's Women's Care & Fertility Clinic, AMH testing is part of our comprehensive fertility assessment for all patients considering pregnancy.
Normal AMH Levels by Age: What's Expected?
AMH levels naturally decline as women age. Understanding age-specific ranges helps put your results in proper context.
Based on the latest 2025 research, here are the age-stratified AMH reference ranges:
| Age Range | Normal AMH (ng/mL) | Status |
|---|---|---|
| 25-30 years | 2.5 - 6.5 | Optimal |
| 31-35 years | 1.5 - 4.0 | Good |
| 36-40 years | 0.5 - 2.5 | Moderate |
| 41-45 years | 0.3 - 1.5 | Lower |
| Any age | < 1.2 | Diminished Reserve |
Key Finding from 2025 Research: Studies show that an AMH level below 1.2 ng/mL reliably indicates diminished ovarian reserve at any age and predicts reduced egg retrieval numbers and lower pregnancy success in IVF treatment. This threshold is now used as a clinical cutoff for treatment planning.
What Does Low AMH Actually Mean?
This is where confusion often begins.
When patients receive a "low AMH" result, many assume it means they cannot get pregnant. That's not accurate.
Low AMH Means:
Fewer eggs remaining — Your ovarian reserve is lower than expected for your age
Reduced response to IVF — Ovarian stimulation may yield fewer eggs during fertility treatment
Time sensitivity matters — It may be wise to pursue fertility goals sooner rather than later
Low AMH Does NOT Mean:
- You cannot get pregnant naturally — many women with low AMH conceive on their own
- Your eggs are poor quality — AMH measures quantity, not quality
- You are in menopause — low AMH can occur years before menopause
- IVF will definitely fail — success is still possible with personalized protocols
Real Patient Story:
"I was 32 when my AMH came back at 0.8 ng/mL. I was devastated. Dr. Vrushni explained that while my egg count was lower, the eggs I had were still good quality because of my age. We did one cycle of IVF with ICSI, retrieved 6 eggs, and I'm now 7 months pregnant. Low AMH isn't the end — it's just information."
— Priya M., Powai, Mumbai
What Causes Low AMH?
Understanding why your AMH is low can help guide treatment decisions.
Common Causes Include:
- 1. Age (Most Common Factor)
- Ovarian reserve naturally declines with age, accelerating after age 35. This is biological, not preventable, but can be managed with timely planning.
- 2. Genetic Factors
- Some women are born with fewer eggs or experience earlier decline due to genetic predisposition. Family history of early menopause may be a clue.
- 3. Ovarian Surgery or Damage
- Previous surgery for ovarian cysts, endometriomas, or other conditions can reduce ovarian reserve.
- 4. Endometriosis
- Endometriosis, especially when it affects the ovaries, can lower AMH levels and impact egg quality.
- 5. Chemotherapy or Radiation
- Cancer treatments can significantly affect ovarian reserve. Fertility preservation before treatment is crucial.
- 6. Autoimmune Conditions
- Conditions like thyroid disorders or autoimmune oophoritis can affect ovarian function.
- 7. Lifestyle Factors
- Smoking, obesity, vitamin D deficiency, and chronic stress can negatively impact ovarian reserve.
Can AMH Levels Improve?
This is the question every patient with low AMH wants answered.
The honest answer: AMH cannot be significantly increased.
You cannot "grow back" eggs. However, you can optimize the quality and function of the eggs you do have.
Evidence-Based Ways to Support Ovarian Health:
- Vitamin D Supplementation
Studies show vitamin D may support follicle development. Aim for levels above 30 ng/mL.
- CoQ10 (Ubiquinol)
An antioxidant that may improve egg quality. Typical dose: 200-600 mg daily.
- Healthy Weight Maintenance
Both underweight and obesity can affect ovarian function. BMI between 18.5-25 is ideal.
- Mediterranean Diet
Rich in antioxidants, omega-3s, and whole foods that support reproductive health.
- Stress Management
Chronic stress affects hormone balance. Yoga, meditation, and adequate sleep are beneficial.
- Quit Smoking
Smoking accelerates ovarian aging. Quitting can prevent further decline.
- Acupuncture
Some studies suggest acupuncture may improve blood flow to the ovaries.
Important: While these lifestyle modifications may help, improvements in AMH are typically modest (10-20% at best). The primary goal is optimizing egg quality and creating the best conditions for conception, not dramatically raising AMH numbers.
Treatment Options for Low AMH
Low AMH doesn't mean the end of your fertility journey. It means you need a personalized, strategic approach.
Options Include:
1. Trying Naturally (If Appropriate)
For women under 35 with low but not severely diminished AMH, timed intercourse with ovulation tracking may be worth trying for 3-6 months.
Best for: Women under 35, no other fertility issues
2. IUI (Intrauterine Insemination)
IUI with mild ovarian stimulation can work for women with low AMH if tubes are open and sperm quality is good.
Best for: Mild-moderate low AMH, no tubal issues
3. IVF with Personalized Protocols
IVF remains the most effective option for low AMH. Specialized stimulation protocols can maximize egg retrieval while maintaining quality.
- Mini IVF: Lower medication doses, gentle stimulation
- Natural cycle IVF: Minimal or no medication
- Micro-dose flare protocol: For poor responders
- ICSI: Maximizes fertilization rates with limited eggs
Best for: Most women with diminished ovarian reserve
4. Egg Freezing (If Delaying Pregnancy)
If you're not ready for pregnancy now but your AMH is declining, egg freezing can preserve your current fertility potential.
Best for: Women under 38 wanting to delay pregnancy
5. Donor Eggs
For women with very low AMH (< 0.3 ng/mL) or repeated IVF failures, donor eggs offer excellent success rates.
Best for: Severely diminished reserve, advanced age
When Should You Test Your AMH?
AMH testing isn't for everyone, but it's valuable in certain situations.
Consider Testing If:
- You're over 35 and planning to conceive soon
- You have irregular or absent periods
- You're considering delaying pregnancy and want to know your timeline
- You have a family history of early menopause
- You've been diagnosed with endometriosis or PCOS
- You're planning fertility treatment like IVF
- You've had previous ovarian surgery
- You're a cancer survivor who had chemotherapy
How Often Should You Retest?
- If normal: Every 12-18 months
- If low or borderline: Every 6-12 months
- During fertility treatment: As recommended by your doctor
Frequently Asked Questions
Can I get pregnant naturally with AMH of 0.5?
Yes, natural pregnancy is possible with AMH of 0.5 ng/mL, especially if you're under 35 and have good egg quality. However, time is critical. Try naturally for 3-6 months with ovulation tracking, then consider fertility treatment if unsuccessful.
Does birth control affect AMH levels?
Birth control pills can temporarily lower AMH levels by 20-30% while you're taking them. However, levels return to normal within 3-6 months of stopping. Long-term birth control does not permanently damage ovarian reserve.
Can PCOS cause high AMH?
Yes, women with PCOS often have elevated AMH levels (above 5-7 ng/mL) due to increased follicle count. While high AMH suggests more eggs, PCOS can still affect egg quality and ovulation.
Is AMH more important than FSH?
AMH is more stable and can be tested any day of the cycle, making it more convenient. FSH is cycle-dependent and must be tested on Day 2-3. Both provide valuable but different information about ovarian reserve. We typically use both for comprehensive assessment.
What's the cost of AMH testing in Mumbai?
AMH testing in Mumbai typically costs ₹1,500-3,000 depending on the lab. At our clinic, AMH is included as part of comprehensive fertility assessment packages to make testing more accessible.
Final Thoughts: Knowledge Is Power
AMH testing is not meant to create fear. It's meant to provide information.
Whether your AMH is high, low, or somewhere in between, what matters most is what you do with that information.
If your AMH is low:
- Don't panic — pregnancy is still possible
- Act sooner rather than later
- Work with a fertility specialist who understands diminished ovarian reserve
- Consider all your options, including IVF and egg donation
- Focus on optimizing egg quality through lifestyle
At Dr Vrushni's Women's Care & Fertility Clinic in Mumbai, we specialize in helping women with diminished ovarian reserve achieve pregnancy through personalized treatment protocols.
Low AMH doesn't mean no hope. It means you need expert guidance, a clear plan, and realistic expectations.
And that's exactly what we're here to provide.
Concerned About Your AMH Levels?
Book a consultation with Dr Vrushni Bhuta to discuss your AMH results, understand your fertility timeline, and create a personalized plan.
Book ConsultationAvailable at Hiranandani Powai, Surya Santacruz & Bookurdoc Chandivali
Medical Disclaimer: This article is for educational purposes only and does not constitute medical advice. AMH levels should always be interpreted by a qualified fertility specialist in the context of your complete medical history, physical examination, and other fertility tests. Individual results and treatment outcomes vary. Please consult Dr Vrushni Bhuta or a qualified healthcare provider for personalized guidance.