Your AMH level is a marker of your ovarian reserve, the pool of small follicles still active in your ovaries. It is not a measure of whether you can get pregnant, and it does not predict a specific egg count. For a 30-year-old woman the median AMH sits around 14 pmol/L (about 2.0 ng/mL); for a 40-year-old, around 3 pmol/L. What that number means for you depends on your age, your cycle and what you intend to do with the result.
We get this question at Lunara more often than any other fertility question. Women want to know where they stand, especially when they are still weighing up timing, egg freezing or starting an IVF pathway. Below we explain what AMH actually measures, which values match which age, and when testing is and is not worth doing.
What is AMH and what does it say about fertility?
AMH stands for anti-Müllerian hormone. It is produced by the small, immature follicles in your ovaries. The more of these follicles are active, the higher your AMH level in the blood. AMH is therefore used as a biomarker for ovarian reserve.
One important caveat: AMH measures the size of the pool, not the quality of your eggs. A normal AMH does not guarantee an easy pregnancy. A low AMH does not rule out conceiving. Research suggests AMH is a reasonable predictor of the response to IVF stimulation, but a weak predictor of natural conception (Iliodromiti et al., 2014, PMID 24532220).
The value is a piece of the puzzle, not the verdict.
Normal AMH values by age
AMH falls naturally with age. The table below shows median values per age band, based on the widely used La Marca et al. (2010) nomograms. Labs can differ in assay methods, so any individual value is read in context.
| Age | Median AMH (pmol/L) | Median AMH (ng/mL) | Usual interpretation |
|---|---|---|---|
| 20 to 25 | 20 to 30 | 2.8 to 4.2 | Reserve in line with age |
| 26 to 30 | 14 to 22 | 2.0 to 3.1 | Reserve in line with age |
| 31 to 35 | 8 to 15 | 1.1 to 2.1 | Reserve in line with age |
| 36 to 40 | 3 to 9 | 0.4 to 1.3 | Lower reserve than younger groups |
| 41 to 45 | 0.5 to 4 | 0.07 to 0.6 | Reserve declining toward menopause |
The spread within each age band is wide. Two healthy 32-year-olds can have values that differ by a factor of three, without either being less fertile. That is why AMH alone is never a diagnosis.
When is an AMH test worth doing?
An AMH test can be useful in a handful of specific situations. Not every woman benefits from testing, and for some groups the result adds little new information.
Consider an AMH test if any of these apply:
- You are thinking about timing for children and want to know whether you still have headroom
- You are considering egg freezing (social freezing)
- You have symptoms that may fit PCOS, where AMH is often raised
- There is a family history of early menopause (before age 45)
- You are at the start of an IVF pathway and want to gauge the response to stimulation
When is testing probably less useful? If you are using the pill, a hormonal IUD or other hormonal contraception. Research suggests hormonal contraception can temporarily lower AMH (Hagen et al.). For a reliable picture, you ideally wait a few months after stopping.
An AMH value is a pointer, not a verdict.
A low AMH value: what does it mean for your options?
A low AMH for your age can land hard. The number touches a future you may already have in mind. At the same time: it is a snapshot, not a sentence. Women with low AMH conceive naturally all the time. Women with high AMH sometimes do not. What the value does is help you have realistic conversations about your options.
Broadly, three paths come up after a low result:
- Path 1: retest in three to six months. AMH can vary between measurements. One low value is not a pattern. A second reading is usually more useful than re-interpreting the first.
- Path 2: a fertility consultation with a gynaecologist. For women under 35 with an active wish to conceive, a broader workup (AMH plus antral follicle count and FSH) gives a fuller picture. Bring your AMH result to that conversation.
- Path 3: a conversation about social freezing. If a pregnancy is not on the cards yet, a low AMH can be a reason to consider freezing eggs. A clinical geneticist or fertility doctor can help you weigh that up.
Which path fits depends on age, situation and what you want. What we do not recommend: ignoring the value, or reacting with panic. Discuss your result with your GP or a fertility doctor before making decisions.
Can your AMH value still change?
Over the long term, AMH declines with age. That decline is gradual and not reversible. Over the short term, a measured value can shift due to cycle phase, lab variation and factors such as hormonal contraception or recent ovarian surgery (Iliodromiti et al., 2014).
What does not meaningfully raise AMH: supplements, diet or exercise. There are studies on DHEA and vitamin D in women with low AMH, but the effects are small and the evidence is mixed. Discuss any such options with a doctor; unsupervised supplementation carries its own risks.
One value is therefore an estimate, not a fixed number.
AMH together with FSH and oestradiol
While AMH can be measured reliably on any cycle day, AMH alone does not give a full fertility picture. For broader context AMH is often combined with FSH and oestradiol on cycle days 2 to 5. See our piece on when an FSH test is worth doing and the guide to which blood test fits a wish to conceive.
For a broader fertility overview, see our pillar article: fertility testing, what to know before you start.
Testing AMH through Lunara: how it works
At Lunara, AMH is part of the Fertility Assessment, alongside FSH, LH, oestradiol and prolactin. You do not need a GP referral. You order online, book a slot at one of 750+ blood draw locations in the Netherlands, and receive your result digitally within a few working days. A BIG-registered doctor provides context per marker.
For women who suspect PCOS, our PCOS Screening may also be relevant, measuring AMH alongside testosterone, SHBG and other markers.
Frequently asked questions
On which cycle day should I test AMH?
AMH is one of the few hormones you can measure on any cycle day. The value varies minimally across the cycle. If you use hormonal contraception, the result can sit lower than your natural baseline.
Is AMH the same as antral follicle count (AFC)?
No. AMH is a blood measurement; AFC is an ultrasound count of small follicles. The two measure related but not identical aspects of ovarian reserve, and they complement each other rather than substitute.
What counts as a low AMH value?
The threshold depends on your age. A value of 5 pmol/L is normal for a woman of 40, but low for a woman of 28. Always read your result in the context of your age band, and discuss the meaning with a doctor.
How much does an AMH test cost at Lunara?
AMH is included in the Fertility Assessment and PCOS Screening panels. Check the product page for current pricing.
References
- La Marca A, Sighinolfi G, Radi D, et al. Anti-Müllerian hormone (AMH) as a predictive marker in assisted reproductive technology. Hum Reprod Update. 2010;16(2):113-130. PMID: 19793843.
- Iliodromiti S, Kelsey TW, Wu O, Anderson RA, Nelson SM. The predictive accuracy of anti-Müllerian hormone for live birth after assisted conception: a systematic review and meta-analysis. Hum Reprod Update. 2014;20(4):560-570. PMID: 24532220.
- Hagen CP, Sørensen K, Anderson RA, Juul A. Serum levels of antimüllerian hormone in early maturing girls. Fertil Steril. 2012;98(5):1326-1330.
- NHG-Standaard Subfertiliteit (M25). Nederlands Huisartsen Genootschap. nhg.org.
Every blood test result through Lunara includes a professional assessment by a BIG-registered doctor. For treatment decisions, discuss your results with your GP or a fertility doctor.
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