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Hormones

AMH value: egg supply, PCOS and what the result does not predict

In the ovaries of women after puberty, anti-Müllerian hormone, AMH for short, is important for the growth and maturation of the egg sacs, in which eggs mature, according to the NVKC. The support cells of those sacs make the hormone, which is why the AMH value shows how large the follicle supply is.

In polycystic ovary syndrome (PCOS) AMH is strongly raised, and over the years, after surgery on an endometriosis cyst or, in women of reproductive age, after chemotherapy for breast cancer it can fall. Only a blood test shows the value.

Diagnostiek voor U uses its own limit per year of age for women, for example 0.63 to 4.54 µg/l at 35 and 0.24 to 2.83 µg/l at 40. A high AMH does not establish PCOS on its own.

Doctor's Assessment Included

AMH is a measure of the follicle supply in the ovaries, and in women the value falls with age. Star-SHL, Unilabs, Certe and Diagnostiek voor U use limits per age for women.

  • For AMH, Star-SHL uses 1.52 to 9.95 µg/l for women aged 20 to 24 and 0.06 to 4.44 µg/l for those aged 40 to 44.
  • The Dutch guideline for the basic fertility work-up (the first tests for a couple having trouble conceiving) advises against measuring AMH in that work-up.
  • Hormonal contraception can lower AMH: in one study, AMH in users was on average about a quarter lower than in non-users of hormonal contraception, and that effect proved reversible.

Reference Ranges

See the value that applies to you:

Choose male or female — this range differs by sex.

Enter your age — this range changes with age.

This range also depends on context such as cycle phase or sample material; the highlighted rows apply to your group.

Your reference range
ug/l
0,06 9,95 ug/l
Reference ranges by group, in ug/l
Female · 20–24 years 1,52–9,95 ug/l
1,52 9,95
Female · 25–29 years 1,2–9,05 ug/l
1,2 9,05
Female · 30–34 years 0,71–7,59 ug/l
0,71 7,59
Female · 35–39 years 0,41–6,96 ug/l
0,41 6,96
Female · 40–44 years 0,06–4,44 ug/l
0,06 4,44
Female · 45–50 years < 1,79 ug/l
1,79
0,06 9,95 ug/l

Package-insert value: 5th-95th percentile per age group (n = 148 men; 150 at 20-24 years; 150 at 25-29; 138 at 30-34; 138 at 35-39; 142 at 40-44; 169 at 45-50 years). AMH does not depend on the menstrual cycle and can be measured on any cycle day. The reference group did not use hormonal contraception: combined contraception lowers AMH, so a value taken while on the pill can come out low. The lower limit of 0.010 at 45-50 years is the detection limit of the test, not a measured percentile. A hormone reference value is assay-specific; these values apply to the Roche Elecsys method.

Source: Roche Diagnostics Reference population: Roche reference cohort (Elecsys AMH Plus package insert)

Reference ranges may vary between laboratories. When you order a test, a BIG-registered doctor assesses your personal results in context. For treatment decisions, discuss your results with your GP.

Check your own value

AMH (Anti-Müllerian Hormone): what Dutch laboratories use

Reference ranges by group, in ug/l
Star-shl · Female · 20–24 years 1.52–9.95 µg/l
1.52 9.95
Star-shl · Female · 25–29 years 1.20–9.05 µg/l
1.2 9.05
Star-shl · Female · 30–34 years 0.71–7.59 µg/l
0.71 7.59
Star-shl · Female · 35–39 years 0.41–6.96 µg/l
0.41 6.96
Star-shl · Female · 40–44 years 0.06–4.44 µg/l
0.06 4.44
Star-shl · Female · 45–50 years 0.01–1.79 µg/l
0.01 1.79
Unilabs · Female · 20–25 years 1.22–11.70 µg/l
1.22 11.7
Unilabs · Female · 25–30 years 0.89–9.85 µg/l
0.89 9.85
Unilabs · Female · 30–35 years 0.58–8.13 µg/l
0.58 8.13
Unilabs · Female · 35–40 years 0.15–7.49 µg/l
0.15 7.49
Unilabs · Female · 40–45 years 0.03–5.47 µg/l
0.03 5.47
Unilabs · Female · 45–50 years 0.01–2.71 µg/l
0.01 2.71
Unilabs · Female · 50 years and older 0.00–0.05 µg/l
0 0.05
Certe · Female · 20–25 years 1.22–11.70 ug/L
1.22 11.7
Certe · Female · 25–30 years 0.89–9.85 ug/L
0.89 9.85
Certe · Female · 30–35 years 0.576–8.130 ug/L
0.576 8.13
Certe · Female · 35–40 years 0.147–7.490 ug/L
0.147 7.49
Certe · Female · 40–45 years 0.027–5.470 ug/L
0.027 5.47
Certe · Female · 45–50 years 0.01–2.71 ug/L
0.01 2.71
Diagnostiek voor U · Female · 19–20 years 1.22–5.97 µg/L
1.22 5.97
Diagnostiek voor U · Female · 21 years 1.30–6.12 µg/L
1.3 6.12
Diagnostiek voor U · Female · 22 years 1.35–6.28 µg/L
1.35 6.28
Diagnostiek voor U · Female · 23 years 1.41–6.45 µg/L
1.41 6.45
Diagnostiek voor U · Female · 24 years 1.36–6.62 µg/L
1.36 6.62
Diagnostiek voor U · Female · 25 years 1.32–6.79 µg/L
1.32 6.79
Diagnostiek voor U · Female · 26 years 1.26–6.88 µg/L
1.26 6.88
Diagnostiek voor U · Female · 27 years 1.20–6.83 µg/L
1.2 6.83
Diagnostiek voor U · Female · 28 years 1.15–6.74 µg/L
1.15 6.74
Diagnostiek voor U · Female · 29 years 1.11–6.52 µg/L
1.11 6.52
Diagnostiek voor U · Female · 30 years 1.07–6.32 µg/L
1.07 6.32
Diagnostiek voor U · Female · 31 years 0.96–5.97 µg/L
0.96 5.97
Diagnostiek voor U · Female · 32 years 0.87–5.63 µg/L
0.87 5.63
Diagnostiek voor U · Female · 33 years 0.79–5.26 µg/L
0.79 5.26
Diagnostiek voor U · Female · 34 years 0.69–4.87 µg/L
0.69 4.87
Diagnostiek voor U · Female · 35 years 0.63–4.54 µg/L
0.63 4.54
Diagnostiek voor U · Female · 36 years 0.55–4.19 µg/L
0.55 4.19
Diagnostiek voor U · Female · 37 years 0.47–3.85 µg/L
0.47 3.85
Diagnostiek voor U · Female · 38 years 0.39–3.52 µg/L
0.39 3.52
Diagnostiek voor U · Female · 39 years 0.31–3.15 µg/L
0.31 3.15
Diagnostiek voor U · Female · 40 years 0.24–2.83 µg/L
0.24 2.83
Diagnostiek voor U · Female · 41 years 0.20–2.54 µg/L
0.2 2.54
Diagnostiek voor U · Female · 42 years 0.14–2.29 µg/L
0.14 2.29
Diagnostiek voor U · Female · 43 years 0.09–2.05 µg/L
0.09 2.05
Diagnostiek voor U · Female · 44 years 0.07–1.80 µg/L
0.07 1.8
Diagnostiek voor U · Female · 45 years 0.05–1.55 µg/L
0.05 1.55
Diagnostiek voor U · Female · 46 years 0.04–1.44 µg/L
0.04 1.44
Diagnostiek voor U · Female · 47 years 0.03–1.32 µg/L
0.03 1.32
Diagnostiek voor U · Female · 48 years 0.02–1.21 µg/L
0.02 1.21
Diagnostiek voor U · Female · 49 years 0.01–1.11 µg/L
0.01 1.11
Diagnostiek voor U · Female · 50 years · a limit, not a range < 1.01 µg/L
1.01
Diagnostiek voor U · Female · 52 years and older · a limit, not a range · after menopause < 0.1 µg/L
0.1
0 12.87 ug/l

Source: Star-shl

Source: Unilabs

Source: Certe

Source: Diagnostiek voor U

Each value as the laboratory itself publishes it, retrieved in 2026.

AMH (Anti-Müllerian Hormone): what this test measures

The result gives AMH as a concentration in the blood, in micrograms per litre (µg/l). According to the Dutch guideline for the basic fertility work-up (the first tests for a couple having trouble conceiving), the value relates best to the number of small antral follicles on ultrasound.

Laboratories use limits per age for women, for example Star-SHL with 1.20 to 9.05 µg/l from 25 to 29 and 0.06 to 4.44 µg/l from 40 to 44. According to Star-SHL, women over 50 generally show an AMH below 0.03 µg/l.

AMH (Anti-Müllerian Hormone): why this value matters

According to the 2023 international PCOS guideline, AMH could be used in adult women to establish whether the ovaries are polycystic, with many small follicles. That guideline advises against using AMH as the single test for the diagnosis of PCOS (polycystic ovary syndrome), and says AMH should not yet be used in adolescents. Guidelines differ on that role: the Dutch 2023 PCOS guideline, an adaptation of the 2018 international text, advises against using AMH as a replacement for the ultrasound. The NVKC also combines AMH with an ultrasound.

In women of reproductive age with breast cancer, a 2017 study calls AMH a relevant tool to assess and follow the follicle supply during treatment.

AMH (Anti-Müllerian Hormone): how the blood test works

Referral
No GP referral needed. After the order we arrange the referral through ZorgDomein, within one business day; orders after 17:00 or at the weekend start on the next business day. ZorgDomein emails a barcode, and that barcode is what the draw site needs.
The draw
A blood draw from a vein in the arm, at a partner laboratory's draw site. No home kit, no finger prick.
Which test
AMH Test · €89,- · Fertility Assessment · €139,- · PCOS Screening · €159,- · IVF Blood Test (Women) · €425,-
Where
650+ draw sites run by independent laboratories across the Netherlands. Draw sites

AMH (Anti-Müllerian Hormone): how to prepare

Nothing special is needed for these tests.

  1. Your cycle does not matter here

    Good to know

    This value barely changes, including through a menstrual cycle. Any day works.

  • Water is always fine. Drink as usual beforehand, it makes the draw easier.
  • Take your usual medication, unless your own doctor told you otherwise.

AMH (Anti-Müllerian Hormone): when is testing worthwhile?

With suspected premature ovarian insufficiency, which the European guideline defines as the ovaries stopping before age 40, and when polycystic ovary syndrome (PCOS) is investigated, a doctor can request AMH, as before IVF treatment.

According to the European guideline on premature ovarian insufficiency, AMH is not the first test for that diagnosis, but it may help when the FSH (follicle-stimulating hormone) result is inconclusive.

AMH (Anti-Müllerian Hormone): symptoms of a high or low value

Low Levels

In premature ovarian insufficiency, in which, according to the European guideline, the ovaries stop before age 40, AMH can be low; according to the European guideline, that diagnosis requires a raised FSH (follicle-stimulating hormone). AMH can also be low after surgery on an endometriosis cyst, and in women of reproductive age with breast cancer also after chemotherapy.

In women who kept a cycle after cancer treatment, an undetectably low AMH does not appear to be linked to reduced fertility according to the Dutch guideline for the basic fertility work-up.

High Levels

In polycystic ovary syndrome (PCOS), with many small follicles in the ovaries, AMH can be strongly raised. According to the international PCOS guideline, the diagnosis is simpler when an irregular cycle and signs of too many male hormones are present together; in that case an ultrasound or AMH is not needed.

AMH (Anti-Müllerian Hormone): causes of a low or high value

What lowers the value

  • Age

    The amount of AMH falls in women from a certain age, while FSH rises.

  • Premature ovarian insufficiency

    In premature ovarian insufficiency, in which, according to the European guideline, ovarian function stops before age 40, AMH can be low. According to the European guideline, an AMH test may help confirm that diagnosis when the FSH result is inconclusive, but it is not the primary test.

  • Hormonal contraception

    Users of hormonal contraception had on average about a quarter lower AMH values in one study than women not using hormonal contraception; that effect proved reversible.

  • Surgery on an endometriosis cyst

    After removal of an endometriosis cyst, AMH fell on average in a review of studies, which suggests a possible negative effect on the egg supply, although the studies differed widely.

  • Chemotherapy for breast cancer

    In women of reproductive age with breast cancer, AMH fell to undetectable levels during chemotherapy in most and generally stayed very low afterwards in most.

What raises the value

  • Polycystic ovary syndrome (PCOS)

    In women with PCOS, AMH is strongly raised according to the NVKC, and according to the NVKC the result must be combined with a transvaginal ultrasound, an internal scan through the vagina, for the diagnosis.

AMH (Anti-Müllerian Hormone): lifestyle and this value

Note which form of hormonal contraception you use when you have an AMH result assessed, because it can lower AMH. That also applies to progestogen-only forms, with a hormone similar to the body's own progesterone, such as the implant and the mini-pill.

AMH (Anti-Müllerian Hormone): frequently asked questions

Can I have PCOS with a high AMH?

Yes, a high AMH can fit polycystic ovary syndrome (PCOS), but AMH alone does not make that diagnosis. According to the international PCOS guideline, either AMH or an ultrasound may be used in adults to establish polycystic ovaries, but both tests should not be performed, to limit over-diagnosis. The NVKC, by contrast, combines the result with an ultrasound.

Does AMH fall after endometriosis cyst surgery?

Yes, after removal of an endometriosis cyst, AMH fell on average by about 1.1 ng/ml, which is about 1.1 µg/l, in a review of studies. The authors see a possible negative effect on the egg supply in that, although the studies differed widely.

Does AMH predict my chance of pregnancy?

Probably not: the 2025 European guideline on ovarian stimulation for IVF (in vitro fertilisation) does not recommend AMH for predicting a pregnancy or the birth of a live child in IVF. According to that same guideline, AMH does help estimate how the ovaries respond to that stimulation.

AMH (Anti-Müllerian Hormone): sources

  1. Roche Diagnostics. Elecsys AMH Plus, Method Sheet 08818061500 V 2.0, 2024-12 (CE). Materiaal 08818061190. Studie RD001727 (148 mannen, 887 vrouwen zonder anticonceptie). Verwachte waarden: 5e-95e percentiel. (retrieved 2026) elabdoc-prod.roche.com
  2. Star-shl, Labbepalingen (referentiewaarden per bepaling), star-shl.nl, geraadpleegd 2026-10-01 (retrieved 2026) star-shl.nl
  3. Unilabs, Bepalingenklapper (referentiewaarden per bepaling), bepalingenklapper.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenklapper.nl
  4. Certe, Bepalingenwijzer (referentiewaarden per bepaling), bepalingenwijzer.certe.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenwijzer.certe.nl
  5. Diagnostiek voor U, eLabgids (Referentiewaarden DvU), diagnostiek.getincontrol.eu, geraadpleegd 2026-10-01 (retrieved 2026) diagnostiek.getincontrol.eu
  6. NVKC, Alles over testen: AMH, allesovertesten.nl, geraadpleegd 2026-10-07 (retrieved 2026) allesovertesten.nl
  7. ESHRE. Evidence-based guideline: premature ovarian insufficiency. 2024 (retrieved 2026) pmc.ncbi.nlm.nih.gov
  8. Bernardi LA et al. Duration, recency, and type of hormonal contraceptive use and antimüllerian hormone levels. Fertil Steril 2021 (retrieved 2026) pmc.ncbi.nlm.nih.gov
  9. Raffi F, Metwally M, Amer S. The impact of excision of ovarian endometrioma on ovarian reserve: a systematic review and meta-analysis. J Clin Endocrinol Metab 2012 (retrieved 2026) pubmed.ncbi.nlm.nih.gov
  10. Fréour T, Barrière P, Masson D. Anti-müllerian hormone levels and evolution in women of reproductive age with breast cancer treated with chemotherapy. Eur J Cancer 2017 (retrieved 2026) pubmed.ncbi.nlm.nih.gov

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