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Anti-Mullerian Hormone (AMH)

A hormone made by small growing follicles in the ovaries. It reflects how many are growing and is used as a clue to ovarian reserve.

AI-verified against cited sources. Awaiting expert reviewAlso called AMH, MISLOINC 38476-8

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What it is

Anti-Müllerian hormone (AMH) is made by cells in the small growing follicles of the ovary. Its level in the blood tracks the number of those growing follicles. This is sometimes called the functional ovarian reserve. AMH is highest in young adult women and falls with age until it is nearly undetectable after menopause. Boys and men also make AMH in the testes, at high levels in early childhood.

Why it matters

AMH is mostly used to estimate how the ovaries may respond to fertility medicines, and as one clue in a polycystic ovary syndrome (PCOS) work-up. It is not a pregnancy test or a fertility score. The 2026 NICE guideline says not to use AMH to predict the chance of becoming pregnant without treatment. It says AMH or an ultrasound follicle count can help predict ovarian response to assisted conception. The American Society for Reproductive Medicine says markers like AMH are poor predictors of reproductive potential independent of age. In boys, AMH can help clinicians look into testicular function.

If it’s low

AMH falls naturally with age, and it is near zero after menopause. A lower-than-typical result means fewer small follicles are growing right now. It does not by itself mean you can't get pregnant, because age matters more and AMH does not predict natural conception on its own. Hormonal birth control, ovarian surgery, chemotherapy and smoking can also lower it.

Common causes

  • Normal aging and the approach of menopause
  • Hormonal birth control (studies disagree on the size of the effect)
  • Higher body mass index, which was linked to lower AMH in several studies
  • Smoking, which was linked to about 9% lower AMH in a large study
  • Surgery on the ovaries
  • Chemotherapy
  • Primary ovarian insufficiency or Turner syndrome

What can help

  • Ask whether your result changes any of your plans, since AMH is only one piece of information
  • Ask whether an ultrasound follicle count would add useful information
  • Ask whether birth control or a recent treatment could explain the number

If it’s high

A high AMH usually means many small follicles are growing. This is common in young women and in PCOS, where AMH can run two to five times above the typical value for age. A high result is not a diagnosis. A very high AMH can also mean a stronger response to fertility medicines, which is why fertility clinics watch it. Rarely, a tumor of the ovary's granulosa cells makes AMH.

Common causes

  • Being in your 20s, when AMH is usually highest
  • Polycystic ovary syndrome (PCOS)
  • Rarely, a granulosa cell tumor of the ovary
  • In boys, early childhood, when levels are naturally high

What can help

  • Ask how your result fits with your cycles, an ultrasound and your other hormones
  • If you are planning fertility treatment, ask how AMH shapes the plan
  • Ask whether the same lab and method should be used for repeat tests

Usual ranges

What labs print as the reference range, by who was tested. Ranges differ a little between labs, so the range on your own report is the one your result is judged against.

The usual range depends on sex and age. Choose women or men to see the one that applies.

Children and teens 7 ranges

See AMH by age and sex, with the U.S. survey numbers where they exist.

If this applies to you

AMH means a little more for some people. Open the one that fits you.

PCOS

In adults, the 2023 guideline allows AMH as an alternative to an ovarian ultrasound for one of the PCOS criteria. It isn't needed when periods are irregular and androgens are raised, it isn't meant as a single test, and it isn't used in teens yet.

Blood tests for PCOS

Trying to conceive

AMH helps predict how the ovaries may respond to the medicines used in IVF, and NICE uses it to help counsel about the chance of a live birth with assisted conception. NICE says it should not be used to predict the chance of getting pregnant without treatment. ASRM says it can be drawn on any day of the cycle.

Blood tests for trying to conceive, including IVF

How common is your level?

NHANES describes the US civilian, non-institutionalized population, not a 'healthy' reference group. People with disease, on medication, fasting or not (except fasting-subsample markers), smokers and so on are all included. A percentile says where a value sits among Americans of that sex and age, not whether it is normal.

How AMH varies with age in the U.S.Shaded: middle 90% and middle 50% of people. Line: the median. ng/mL. Point at any age, or focus the chart and use the arrow keys, to read both sexes in words.

Use the left and right arrow keys to read each age. Shift moves five years.

Reference data derived from CDC/NCHS National Health and Nutrition Examination Survey (NHANES), cycles 2017-March 2020 (pre-pandemic), August 2021-August 2023. Analysis by bloodtesttracker.com; not endorsed by CDC, NCHS or HHS.

Explore AMH by age and sex: every percentile as a table, with a download.

What can affect your result

  • Age: levels are highest in the 20s and fall toward menopause
  • Sex: girls and boys follow very different patterns, and boys have high levels in early childhood
  • PCOS, which raises AMH
  • Hormonal birth control, ovarian surgery, chemotherapy and smoking, which can lower it
  • Body mass index
  • The assay used: there is no international standard, so labs and methods give different numbers
  • Cycle day: a small amount of variation across the cycle has been reported, up to about 20% in some studies
  • Hormonal birth control can lower AMH, although studies disagree on how much. Some report 30% to 40% lower levels with the pill or progestin-only pill (Moolhuijsen and Visser 2020).
  • Chemotherapy lowers AMH quickly, often to nearly undetectable levels. Surgery on the ovaries can also lower it.
  • AMH assays are not interchangeable, because there is no international standard. Results from different assays or labs should not be compared directly.
  • High-dose biotin supplements can affect some immunoassays. Ask your lab or clinician whether to pause biotin before the draw.
  • Sample handling matters: UW Medicine asks for the serum to be separated within 2 hours.

Any time of day. Some labs ask for days 2 to 4 of the menstrual cycle, but a study of one automated assay concluded the level can be drawn at any point in the cycle. AMH changes slowly with age. It can fall quickly after chemotherapy or ovarian surgery.

When to talk to a clinician

Talk with a clinician if your periods have stopped for several months in a row without a clear reason, are very irregular, or if you have hot flashes or night sweats well before the usual age of menopause. AMH alone does not answer these questions, and a clinician will usually look at other hormones too.

Questions you could ask

  • Should I use the same lab and assay for repeat tests?
  • What else, such as an ultrasound follicle count, would help put this in context?
  • Does my result fit with my cycles, an ultrasound and my other hormones?
  • If I am planning fertility treatment, how does this result shape the plan?
  • How does my result compare with others my age measured by the same method?
  • Could birth control or a past treatment explain it?

Questions people ask

Does a low AMH mean I can't get pregnant?

No. The 2026 NICE guideline says not to use AMH to predict pregnancy without treatment, and the American Society for Reproductive Medicine says markers like AMH are poor predictors of reproductive potential independent of age. AMH is mainly useful for estimating how the ovaries may respond to fertility medicines. Talk with your clinician about what your result means for you.

Why does my report show a different unit or range than someone else's?

Labs use different assays, and there is no international standard for AMH. Some labs report ng/mL and others report pmol/L, and 1 ng/mL is about 7.14 pmol/L. Compare results only from the same lab and method.

Does the day of my cycle matter?

A little. One study of an automated assay found AMH stable enough to be drawn at any time in the cycle, while other studies report up to about 20% variation within a cycle. Some labs, such as UW Medicine, still ask for a draw on days 2 to 4.

Show the science and sources

Units

  • 1 ng/mL = 1 ng/mL
  • 1 ng/mL = 7.14 pmol/L

Open the AMH unit converter

Is a change real?

AMH naturally varies about 3.5% from test to test in the same healthy person. Between two results from the same lab, a change of roughly 11% or more is unlikely to be day-to-day noise or lab variation (95% reference change value). Source: Biological variation of serum Anti-Mullerian Hormone in healthy adult men (Kilincer RB et al.).

For clinicians and researchers

AMH is a dimeric glycoprotein of the TGF-beta family made by granulosa cells of preantral and small antral follicles. It correlates with the number of growing follicles (the functional ovarian reserve) rather than with the dormant primordial pool, and it is an indirect marker (Moolhuijsen and Visser 2020). Sertoli cells make AMH in males. Because no international standard exists, assays differ, and the common conversion 1 ng/mL = 7.14 pmol/L is assay-dependent. Intracycle variation up to about 20% has been reported, while a multicenter study of the Access assay found an intraclass correlation of 0.91 across the cycle (Gracia 2018). A Roche Elecsys AMH Plus study estimated unexplained biological variability at 9.6% and analytical variability at 3.5% (BICYCLE study). Hormonal contraception effects are conflicting. Chemotherapy lowers AMH rapidly. The 2023 international PCOS guideline says AMH could be used to define polycystic ovarian morphology in adults when used within the diagnostic algorithm, not as a single test, and should not yet be used in adolescents. NICE NG257 (2026) recommends against using AMH to predict spontaneous pregnancy, recommends AMH or antral follicle count as predictors of ovarian response, and recommends against FSH for that purpose. Reference intervals here are Roche Elecsys intervals (UW Medicine). Labcorp's Endocrine Sciences intervals, from a different assay, are similar in shape but not identical: for example 1.23-11.51 ng/mL at ages 20-25 and up to 0.82 ng/mL at ages 47-54.

LOINC 38476-8 (primary), 83104-0, 48377-6, 83105-7. Specimen: serum-or-plasma.

Sources

  1. Anti Mullerian Hormone, UW Medicine Laboratory Test Guide (Roche cobas e801 ECLIA), UW Medicine Laboratory Medicine and Pathology (2026)
  2. Endocrinology Expected Values and S.I. Unit Conversion Tables, Labcorp (Endocrine Sciences specialty testing) (2021)
  3. Fertility problems: assessment and treatment (NICE guideline NG257), investigation of fertility problems, National Institute for Health and Care Excellence (2026)
  4. Testing and interpreting measures of ovarian reserve: a committee opinion, American Society for Reproductive Medicine (Fertility and Sterility) (2020)
  5. Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome, Journal of Clinical Endocrinology & Metabolism (2023)
  6. Anti-Müllerian Hormone and Ovarian Reserve: Update on Assessing Ovarian Function, Journal of Clinical Endocrinology & Metabolism (2020)
  7. Multi-center clinical evaluation of the Access AMH assay to determine AMH levels in reproductive age women during normal menstrual cycles, Journal of Assisted Reproduction and Genetics (2018)
  8. Intra- and inter-cycle variability of anti-Müllerian hormone (AMH) levels in healthy women during non-consecutive menstrual cycles: the BICYCLE study, Clinical Chemistry and Laboratory Medicine (2022)
  9. Anti-Müllerian Hormone Levels Across Phenotypes in Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis, Journal of the Endocrine Society (2026)
  10. E-cigarette use (vaping) and cigarette smoking are associated with reduced markers of ovarian reserve: a cross-sectional study of 16,087 women, BMC Women's Health (2026)

AI-verified against cited sources. Awaiting expert review. Last reviewed 2026-10-03. How we build and check these pages.

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