AMH

AMH (anti-Müllerian hormone) is produced by small ovarian follicles, so its blood level helps assess ovarian reserve. It does not show the exact number of remaining eggs. The test is most often performed in infertility investigations and before medically assisted reproduction (MPO), and blood may be taken on any cycle day.

Who is this test for

• women preparing for MPO, to assess ovarian stimulation response and choose a medicine dose;
• women undergoing infertility investigations, alongside FSH, estradiol and ovarian ultrasound;
• women whose ovarian reserve may have decreased, for example after ovarian surgery or before and after chemotherapy;
• adult women with suspected polycystic ovary syndrome (PCOS), as a supplementary finding.

What AMH is and what it shows

In women, AMH is secreted by cells of small developing follicles, the sacs in which eggs mature. More such follicles mean higher AMH. Follicle numbers naturally fall with age, as does AMH, becoming almost undetectable before menopause.

AMH helps assess ovarian reserve and expected stimulation response but does not show the exact number or quality of remaining eggs. It is therefore interpreted together with FSH and ultrasound antral follicle count; unlike FSH, it changes little during the cycle. In men and boys, AMH is produced by the testes, and testing is rare, mainly within investigations led by a paediatric endocrinologist.

What AMH cannot tell you

AMH is not a natural fertility test. In women without an infertility diagnosis, low or high AMH does not predict the likelihood of conceiving naturally over the next several months. Age matters more for pregnancy chances because egg quality depends on it.

AMH also does not reliably predict when an individual woman will enter menopause. British NICE guidelines state that AMH is not used to diagnose perimenopause or menopause in women over 45, in whom menopause is recognised through symptoms and cycle changes, and is not routinely used to diagnose premature ovarian insufficiency either. Tests for different stages are described on the menopause panels.

Save with a panel

Test Anti-Müllerian hormone (AMH) is also included in this panel.

Fertility assessment panelTSH, oestradiol, FSH, LH, prolactin and 2Price of individual tests: 149.00€134.00€Details ›

Preparation and sample

A venous blood sample is taken, and fasting is not required. AMH can be sampled on any cycle day. If FSH and estradiol are also measured that day, as in the Fertility Investigation Panel, women with regular cycles provide blood between cycle days 2 and 5 (most often day 2 or 3), or as instructed by their doctor. Because the panel includes prolactin and testosterone, blood is then taken in the morning, at least 2 hours after waking, with 30 minutes of rest beforehand; because of testosterone, come fasting.

Hormonal contraception and pregnancy lower AMH, so tell your doctor if you use contraception or recently stopped. If you take biotin (e.g. hair and nail supplements), mention this at blood collection.

How results are interpreted

AMH is expressed in pmol/L or ng/mL (1 ng/mL corresponds to approximately 7,1 pmol/L). There is no single “normal” value: results are compared with the expected range for age, which also depends on method and is printed on the report. A gynaecologist interprets the result alongside age, FSH, estradiol and ultrasound.

• Low AMH suggests reduced ovarian reserve. In MPO, this usually means fewer eggs will be obtained through stimulation, but does not mean pregnancy is impossible.
• High AMH most often accompanies many small follicles, as seen in polycystic ovary syndrome. AMH alone does not diagnose PCOS: irregular cycles or signs of excess male hormones are also needed, as shown by testosterone. During MPO, high AMH warns of a possible excessive stimulation response, so the doctor adjusts the dose.

How to arrange testing

You can come for blood collection without an appointment or referral at one of our branches throughout Croatia (listed on the Contactpage). Prices for all tests and panels are listed in the service price list. In fertility investigations, AMH is most often measured within the Fertility Investigation Panel, which includes AMH alongside FSH, LH, estradiol, prolactin, testosterone and TSH.

Frequently asked questions

On which cycle day is AMH tested?

Any day. AMH changes little during the cycle and can also be tested when periods are absent. If FSH and estradiol are measured alongside it, blood is taken between cycle days 2 and 5 (most often day 2 or 3), or as instructed by a doctor.

Can I conceive with low AMH?

Yes. Low AMH suggests reduced ovarian reserve; it does not mean poorer-quality eggs or that natural pregnancy is impossible. A gynaecologist assesses chances alongside age and other findings.

Can AMH show when I will enter menopause?

Not reliably. AMH decreases with age, but a single result cannot predict when an individual woman will reach menopause.

Can AMH be increased?

Ovarian reserve cannot be increased, and there is no evidence that supplements raise AMH. If hormonal contraception lowers AMH, it may rise after stopping.