While trying to conceive and holding out hope for that BFP (Big Fat Positive) test result, you will be inundated with so many terms and acronyms that it might become difficult to remember what everything means and what role it plays in your fertility. 

For example, at the start of your fertility journey, you may begin to track your BBT (Basal Body Temperature) to more accurately time your BD (Baby Dance). If you’re interested in learning more about your fertility, your doctor might order an AMH, or anti-mullerian hormone, test, which can help determine your ovarian egg reserve. But what does that really mean? 

Let’s Break it Down: What is AMH?

Let’s take it back to the beginning. As women, we are born with a finite amount of eggs, roughly 1-2 million. From the time of our first menstrual cycle, this number begins to decrease. Why is that? Well, during each menstrual cycle, our body collects a group of follicles, each with an egg inside, in hopes that it might ovulate. Typically, just one egg ovulates per month, and the rest of the eggs inside the follicles that were not chosen then dissolve. Therefore, with each cycle, the number of eggs in our reserve decreases. 

eggs in a carton

So, where does AMH come into play? The follicles that are harvested in our ovaries each month are responsible for producing AMH. Therefore, the hormone is often used by healthcare providers as a marker to test the level of eggs remaining in a woman’s ovarian reserve. 

Your OBGYN or fertility doctor will conduct a hormonal blood test to determine your AMH levels. A high level of AMH, which is considered greater than 1 ng/mL, usually indicates a healthy, normal ovarian reserve. Anything less than 1 ng/mL might indicate that a woman has a lower, or depleted ovarian reserve. 

Who is at risk for low AMH levels?

As people with ovaries age, they naturally begin to lose eggs from that finite amount they were born with. The rate of eggs lost is a steady decline until the age of 30 and then increases rapidly thereafter, and even more so after 35 years of age. 

As a general guideline, the following levels represent the lower limit of serum AMH values by age:

45 years old: 0.5 ng/mL

40 years old: 1 ng/mL

35 years old: 1.5 ng/ mL

30 years old: 2.5 ng/mL

25 years old: 3.0 ng/mL

fertility clinician reviewing results with a patient

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In some cases, an AMH test might come back with false results. For instance, if you’re on an oral birth control pill or have an irregular hypothalamus, your AMH levels may appear lower than they truly are. In these cases, another way to determine a woman’s ovarian reserve is to conduct an antral follicle count during a transvaginal ultrasound. 

AMH: What Your Levels Can Tell You

While an AMH test is a great resource for those contemplating their fertility options, it does not predict the ability to naturally conceive. Low AMH levels do not indicate infertility. Just because a person with ovaries has low AMH levels does not automatically mean they will have a difficult fertility journey. It is completely possible to get pregnant with your own eggs with low AMH. In the same vein, normal or high levels of AMH do not always equate to an easy road to conception. 

Having an AMH test conducted can have several benefits. For starters, it is a great indicator for your OBGYN or fertility doctor to determine your candidacy for certain fertility treatments, i.e. IVF or egg freezing. In simple terms, an AMH test informs your doctors what your ovaries are capable of, where they’re currently at, and what they can handle. Knowing your AMH levels can help you decide the next plan of action for you and your eggs so that you can be proactive rather than reactive. 

three eggs

When should I test my AMH?

Knowledge is power, and AMH tests can be good indicators of where our ovarian reserve stands at the moment of testing. As people with ovaries, we can empower ourselves by gaining as much insight into our own fertility as possible to help us feel even more confident in our decision-making process about what, if anything, we want to do for our fertility health and family planning.

While it won’t tell your whole fertility story, if you think knowing your AMH levels will help you make better-informed choices regarding your own journey toward conception, then talk to your OBGYN or fertility doctor about getting tested! Taking control of our health and fertility when it’s possible and being well-informed is our best defense against the many frustrating unknowns.   

Brighid Flynn is a freelance writer based in Philadelphia where she lives with her husband and puppy. She is just beginning her journey toward motherhood.