AMH — anti-Mullerian hormone — is a protein produced by the small developing follicles in the ovaries. Its blood level reflects the size of the remaining pool of eggs available in the ovaries at any given time. This is what we mean by ovarian reserve, and AMH is currently the most reliable single blood test available for estimating it.
Unlike FSH or estradiol, which fluctuate significantly across the menstrual cycle, AMH remains relatively stable and can be measured at any point in the cycle. This makes it a practical and informative test for any woman undergoing fertility evaluation.
What the results mean in practice:
A high AMH level suggests a good egg count and is generally reassuring in terms of the quantity of eggs remaining. It does not, however, tell us about egg quality — which is largely determined by age
A very high AMH level — particularly in a woman with irregular periods and polycystic-appearing ovaries on ultrasound — may indicate PCOS and is relevant when planning ovulation induction or IVF, as it signals a risk of ovarian hyperstimulation
A low AMH level indicates that the ovarian reserve is diminished — fewer eggs remain than expected for the woman's age. This does not mean conception is impossible, but it does mean that time is an important factor and that fertility treatment may need to begin sooner rather than later
A very low AMH in a young woman may warrant investigation for premature ovarian insufficiency
AMH is always interpreted alongside the antral follicle count on pelvic ultrasound and the woman's age and menstrual history. No single test result dictates treatment. What AMH does is give us an accurate starting point for an honest conversation about a woman's reproductive timeline and the options available to her at Birthright Fertility, Banjara Hills, Hyderabad.
Written by Dr Sudharani Bairraju, MBBS (Sri Venkateswara Medical College, Tirupathi, 1997), DNB Obstetrics and Gynaecology (St Theresa's General Hospital, Hyderabad, 2007), Postgraduate Certification in Clinical Embryology, Fellowship in Minimally Invasive Surgeries, Fellowship in Advanced Gynaecological Endoscopy, Senior Consultant Obstetrician and Gynaecologist, Infertility (IVF) Specialist and Laparoscopic Surgeon, Birthright Fertility by Rainbow Hospitals, Banjara Hills, Hyderabad.
