What does the research show about anti-müllerian hormone (amh)?

Anti-Müllerian hormone (AMH)

AMH falls with age, from a median of 3.03 ng/mL at 25 to 0.31 at 44 in one cohort. It predicts how many eggs IVF stimulation yields. Two US professional bodies state it is not a fertility test for women who are not infertile, and most cohorts found low levels did not delay conception. Assays differ by about a quarter.

Checked 2026-11-13

Status: A blood test ordered by a clinician and also sold direct to consumers by some US laboratories. FDA classifies anti-mullerian hormone test systems as class II devices with special controls, intended for assessing ovarian reserve in women. Their labeling must state that the test is used with other clinical and laboratory findings before fertility therapy, and with the antral follicle count [1]. The World Health Organization has established a Reference Reagent for AMH, and the study behind it found high variability between methods [2].
Measures: The amount of anti-Müllerian hormone in blood, which is made by the cells surrounding each egg in developing ovarian follicles and reflects the number of eggs remaining in the ovaries [3].
Also called: AMH, anti-Mullerian hormone, anti-Müllerian hormone, antimullerian hormone, antimüllerian hormone, AMH blood test, serum AMH, ovarian reserve test, egg count test
Tested for: ovarian reserve, egg count, fertility testing, egg freezing, IVF planning, predicting menopause, early menopause, polycystic ovary syndrome

Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on

Linked in research2

ModerateLinked to the response to IVF stimulation: AMH alone predicted a poor response with an area under the curve of 0.78, against 0.61 for age.
ModerateLinked to earlier menopause at lower AMH for a woman's age, though AMH alone did not predict the age at menopause with precision.

Reported risks0

No risks sourced yet.

Reference ranges

Each range is the one its source published, in ng/mL. Also reported in pmol/L. Where sources differ, each is shown.

Choi and colleagues, 2022, Roche Elecsys AMH immunoassay, women aged 20 to 24

Korean women aged 20 to 24 attending health checkups · [4], [5]

Range	What the source calls it
below 1.6 ng/mL	No name given
1.6 to 10.11 ng/mL	"reference interval"
above 10.11 ng/mL	No name given

The 2.5th and 97.5th percentiles. The median was 5.91 ng/mL. Only 37 women were in this age band, which the authors call too few for a central 95% interval. From 1,953 Korean women aged 20 to 49 tested at health promotion centers in 2019 and 2020. The study did not check for polycystic ovary syndrome or irregular cycles, which the authors say may have raised the upper percentiles. The same table reprints, for women of this age in a Western population measured with the same assay, an interval of 1.22 to 11.70 ng/mL from the assay's multicenter evaluation in 887 women with regular cycles. That figure was read from the Korean paper's table, not from the evaluation itself [4][5].

Choi and colleagues, 2022, Roche Elecsys AMH immunoassay, women aged 25 to 29

Korean women aged 25 to 29 attending health checkups · [4], [5], [6]

Range	What the source calls it
below 0.88 ng/mL	No name given
0.88 to 14.24 ng/mL	"reference interval"
above 14.24 ng/mL	No name given

The 2.5th and 97.5th percentiles in 321 women. The median was 4.70 ng/mL. The interval reprinted for a Western population of this age is 0.89 to 9.85. See the block for ages 20 to 24 for how the study was done [4][5]. In 5,230 women aged 25 to under 45 tested through one hospital laboratory that serves the community, measured with the same assay, the median fell from 3.03 ng/mL at age 25 to 0.31 at age 44 [6].

Choi and colleagues, 2022, Roche Elecsys AMH immunoassay, women aged 30 to 34

Korean women aged 30 to 34 attending health checkups · [4], [5]

Range	What the source calls it
below 0.87 ng/mL	No name given
0.87 to 10.67 ng/mL	"reference interval"
above 10.67 ng/mL	No name given

The 2.5th and 97.5th percentiles in 563 women. The median was 3.81 ng/mL. The interval reprinted for a Western population of this age is 0.58 to 8.13. See the block for ages 20 to 24 for how the study was done [4][5].

Choi and colleagues, 2022, Roche Elecsys AMH immunoassay, women aged 35 to 39

Korean women aged 35 to 39 attending health checkups · [4], [5]

Range	What the source calls it
below 0.22 ng/mL	No name given
0.22 to 8.51 ng/mL	"reference interval"
above 8.51 ng/mL	No name given

The 2.5th and 97.5th percentiles in 444 women. The median was 2.52 ng/mL. The interval reprinted for a Western population of this age is 0.15 to 7.49. See the block for ages 20 to 24 for how the study was done [4][5].

Choi and colleagues, 2022, Roche Elecsys AMH immunoassay, women aged 40 to 44

Korean women aged 40 to 44 attending health checkups · [4], [5]

Range	What the source calls it
below 0.03 ng/mL	No name given
0.03 to 5.61 ng/mL	"reference interval"
above 5.61 ng/mL	No name given

The 2.5th and 97.5th percentiles in 320 women. The median was 1.07 ng/mL. The lower limit is close to the lowest value the assay reports, 0.01 ng/mL. The interval reprinted for a Western population of this age is 0.03 to 5.47. See the block for ages 20 to 24 for how the study was done [4][5].

Choi and colleagues, 2022, Roche Elecsys AMH immunoassay, women aged 45 to 49

Korean women aged 45 to 49 attending health checkups · [4], [5]

Range	What the source calls it
2.56 or below ng/mL	"reference interval"
above 2.56 ng/mL	No name given

The 97.5th percentile in 268 women. The 2.5th, 5th and 10th percentiles were all 0.01 ng/mL, the lowest value the assay reports, so the interval has no lower band here. The median was 0.21 ng/mL. The interval reprinted for a Western population of this age is 0.01 to 2.71. See the block for ages 20 to 24 for how the study was done [4][5].

Zarek and colleagues, 2015, groups used in the EAGeR trial cohort

Women aged 18 to 40 with one or two earlier pregnancy losses who were trying to conceive · [7]

Range	What the source calls it
below 1 ng/mL	"low"
1 to 3.5 ng/mL	"normal"
above 3.5 ng/mL	"high"

The groups the study used to compare time to pregnancy, not percentiles of a reference population. Of 1,202 women, 124 were in the low group, 595 in the normal group and 483 in the high group. The share who became pregnant was 66.1%, 65.2% and 65.2%. One range was applied to all ages, and the abstract names no assay [7].

Steiner and colleagues, 2017, cut point used in the Time to Conceive cohort

Women aged 30 to 44 with no history of infertility, early follicular phase · [8]

Range	What the source calls it
below 0.7 ng/mL	"low"
0.7 or above ng/mL	No name given

The study's own cut point, set to compare the chance of conceiving. The abstract compares 84 women with low values against 579 with normal values and does not print the upper edge of its normal group, so results of 0.7 or above are shown here as one band. Women below the cut point conceived as often as the others [8].

Aslan and colleagues, 2025, cut point for diminished ovarian reserve

Women aged 18 to 45 tested at one university hospital · [9]

Range	What the source calls it
below 1.2 ng/mL	"diminished ovarian reserve"
1.2 or above ng/mL	No name given

A definition the study applied to 22,920 results, not a percentile. One cut point was used at every age, so the share of women below it rose from 15.9% at age 18 to 96% at age 45, and the median fell below 1.2 ng/mL by age 36. The results came from hospital departments that included fertility and endometriosis clinics, not from a reference population. The abstract names no assay [9].

What has been shown to move it

Shown to lower it1

Endometriosis surgeryStrongStudied in womenHow often is not known

Lower anti-Mullerian hormone after endometrioma surgery

Shown to lower anti-Mullerian hormone, a marker of egg supply, after endometrioma surgery in women, by about 35% to 54% in pooled studies.

The numbers and sources

How common: How often is not known: the sources give no rate.
Effect: AMH fell by 1.77 ng/mL at 1 to 6 weeks, 1.17 ng/mL at 2 to 6 months and 2.13 ng/mL at 9 to 18 months after cystectomy, mean falls of 44.4%, 35.1% and 54.2%. Antral follicle counts did not change significantly [15]. A second review found falls of 1.39, 1.13 and 2.12 ng/mL over the same periods, with no difference between removing a cyst from one ovary or both [16].
Population: 650 women in 14 prospective studies [15]. Women in 30 studies [16].
Sources: [15], [16]
Caveats: These are before-and-after measures in the same women, and heterogeneity was high (I² 92% to 94%) [15]. A lower AMH is not the same as lower fertility, which these reviews did not measure.

Type in your own result

How it compares with the reference method

Matched the reference method1

LimitedStudied in women

Across the menstrual cycle

One study found AMH relatively stable across the menstrual cycle, with a within-woman variation of 23.8% and an intraclass correlation of 0.91.

The numbers and sources

Compared with: The same women's samples taken every 3 to 5 days through one cycle
Effect: In 384 samples from 50 women, the within-subject coefficient of variation across the cycle was 23.8%, against 75.1% between women, and the intraclass correlation was 0.91. The authors conclude that AMH is relatively stable across the cycle [21]. The American Society for Reproductive Medicine reports a modest variability within a woman of about 1.3 ng/mL across cycles, and that current guidance does not support serial testing to track ovarian reserve [11].
Population: 50 women aged 18 to 45 with regular cycles at three US centers [21].
Sources: [21], [11], [12]
Caveats: One study of 50 women with one assay. The American Society for Reproductive Medicine also notes that AMH may read lower in women currently using hormonal contraceptives [12].

Did not match the reference method1

Moderate

Between assays

Not shown to match between assays: two automated assays read about 22% to 27% lower than an earlier manual assay, and methods disagreed in a WHO study.

The numbers and sources

Compared with: The Beckman Coulter AMH Gen II manual assay, and other AMH immunoassays on the same samples
Effect: In 83 patients, results from the automated Access and Elecsys assays were 0.781 and 0.729 times the Gen II result, plus a small constant, and the authors report that values from the automated assays were substantially lower [15]. In 1,729 routine samples the Elecsys assay read 24% to 28% lower than the Gen II assay [5]. In 178 samples, one assay read significantly higher and one significantly lower than the Gen II and Access assays, with all pairs correlated above 0.9 [20]. In the World Health Organization study that established a Reference Reagent, 16 valid method and platform combinations gave content estimates with a geometric coefficient of variation of 42%, and the reagent behaved like patient samples in 6 methods, partly in 3 and not in 7 [2].
Population: 83 patients before IVF [15]. 1,729 routine serum samples [5]. 178 serum samples [20]. Seven laboratories [2].
Sources: [15], [5], [20], [2]
Caveats: A cut point or interval set with one assay does not carry over to another. The World Health Organization study notes that the widely cited conversion of 1 ng/mL to 7.14 pmol/L rests on an assumed molecular mass of 140 kDa [2].

What studies tie it to

Linked in research2

ModerateStudied in women

Response to ovarian stimulation in IVF

Linked to the response to IVF stimulation: AMH alone predicted a poor response with an area under the curve of 0.78, against 0.61 for age.

The numbers and sources

Effect: In pooled individual data, age alone predicted a poor response to ovarian stimulation with an area under the curve of 0.61. AMH alone reached 0.78 and the antral follicle count 0.76, and combining the two did not improve on either (0.80, P = 0.19) [13]. The American Society for Reproductive Medicine states that the ability of AMH and the follicle count to predict oocyte yield, and poor and excessive responses, has been well demonstrated, and that extremely low AMH values are not a reason to refuse IVF treatment [12].
Population: 28 study databases with 5,705 women undergoing IVF [13].
Sources: [13], [12]
Caveats: The finding is for women having IVF. It concerns the number of eggs collected, not whether a pregnancy follows (see the next block).

ModerateStudied in women

Age at menopause

Linked to earlier menopause at lower AMH for a woman's age, though AMH alone did not predict the age at menopause with precision.

The numbers and sources

Effect: A systematic review found that studies generally showed lower age-specific AMH associated with an earlier age at menopause. AMH alone could not predict the age at menopause with precision: in women under 40, estimates and confidence intervals ranged from 2 to 12 years. Its predictive value rose with age, as the time to menopause shortened [16]. In one cohort enrolled from 1992 to 2001 and followed to 2013, AMH was the only ovarian reserve test that independently predicted time to menopause (hazard ratio 0.70, 95% CI 0.56 to 0.86), and it narrowed the spread around the predicted age from 20 to 10.1 years without predicting the earliest or latest ages [17].
Population: 41 studies with 28,858 women, 27 of them on the onset of menopause [16]. 155 women with regular cycles aged 21 to 46 at entry, 81 of whom became postmenopausal [17].
Sources: [16], [17], [3], [18], [19]
Caveats: Observational. The American College of Obstetricians and Gynecologists states that more data are needed on AMH as a predictor of time to menopause [3]. The 2024 guideline on premature ovarian insufficiency states that AMH is not the primary diagnostic test for that condition and does not support routine AMH testing to predict it [18]. The 2012 workshop on staging reproductive aging set no AMH figure, citing the lack of standardized assays [19].

Mixed results2

Moderate

Natural conception in women without infertility

Mixed results: three cohorts found low AMH did not lower the chance of natural conception, one larger cohort did, and a pooled analysis found poor predictive value.

The numbers and sources

Effect: In women aged 30 to 44 trying to conceive for 3 months or less, those with AMH below 0.7 ng/mL had a predicted probability of conceiving of 65% by 6 cycles (95% CI 50% to 75%) against 62% (57% to 66%) with normal values, and 84% against 75% by 12 cycles [8]. In women with one or two earlier losses, low AMH (below 1.00 ng/mL) and high AMH (above 3.5) were not associated with the chance of conceiving in a cycle (odds ratios 1.13, 95% CI 0.85 to 1.49, and 1.04, 0.87 to 1.24) [7]. In 102 women planning pregnancy, AMH did not predict time to ongoing pregnancy once age was accounted for [10]. The American Society for Reproductive Medicine's 2026 opinion describes the studies as conflicting: it cites a cohort of 3,150 women in which AMH below 1 ng/mL went with a lower chance of pregnancy, and a meta-analysis of 11 studies with 4,388 women in which AMH had poor predictive value for spontaneous pregnancy (area under the curve 0.59) [11].
Population: 750 women aged 30 to 44 [8]. 1,202 women aged 18 to 40 at four US centers [7]. 102 women planning pregnancy [10].
Sources: [8], [7], [10], [11], [3], [12]
Caveats: Observational. The American College of Obstetricians and Gynecologists states that using AMH for fertility counseling in women without a diagnosis of infertility is not supported by data from high-quality sources, and that a single level in women with presumed fertility does not appear useful in predicting time to pregnancy and is not for use in counseling on it [3]. The American Society for Reproductive Medicine states that markers of ovarian reserve are not to be used as a fertility test for women who are not infertile or whose fertility is untested, or to promote planned egg freezing [12].

ModerateStudied in women

Live birth after IVF

Mixed results: AMH had some association with live birth after IVF in one meta-analysis, which called its predictive accuracy poor, and added nothing to age in another.

The numbers and sources

Effect: In a meta-analysis of 13 studies, the diagnostic odds ratio of AMH for live birth was 2.39 (95% CI 1.85 to 3.08) in women of unknown ovarian reserve and 4.63 (2.75 to 7.81) in women expected to have low reserve. The authors conclude that AMH has some association with live birth and that its predictive accuracy is poor [14]. In pooled individual data, age predicted ongoing pregnancy after IVF with an area under the curve of 0.57 and no ovarian reserve test added to it [13]. Across four assays in one clinic, the accuracy of pregnancy prediction was uniformly low (0.62 to 0.63) [15].
Population: 5,764 women of unknown ovarian reserve and 542 expected to have low reserve [14]. 5,705 women [13]. 83 patients [15].
Sources: [14], [13], [15], [12]
Caveats: Observational. The American Society for Reproductive Medicine states that AMH has only a weak association with oocyte quality, clinical pregnancy rates and live birth rates [12].

Sources

US Food and Drug Administration. 21 CFR 862.1092, Anti-mullerian hormone test system. Electronic Code of Federal Regulations. https://www.ecfr.gov/current/title-21/section-862.1092
Ferguson J, Hockley J, Rigsby P, Burns C. Establishment of a WHO Reference Reagent for anti-Mullerian hormone. Reproductive Biology and Endocrinology. 2020. https://doi.org/10.1186/s12958-020-00641-9
American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 773: The Use of Antimüllerian Hormone in Women Not Seeking Fertility Care. Obstetrics and Gynecology. 2019. https://doi.org/10.1097/aog.0000000000003162
Choi R, Lee SG, Lee EH. Reference intervals of anti-Müllerian hormone in Korean women. Journal of Clinical Laboratory Analysis. 2022. https://doi.org/10.1002/jcla.24525
Anckaert E, Öktem M, Thies A, et al. Multicenter analytical performance evaluation of a fully automated anti-Müllerian hormone assay and reference interval determination. Clinical Biochemistry. 2016. https://doi.org/10.1016/j.clinbiochem.2015.10.008
Machtinger R, Hemi R, Barhod E, Ziv-Baran T. Population-based age-specific reference percentiles and Z-scores for AMH in women. Human Fertility. 2026. https://doi.org/10.1080/14647273.2025.2610909
Zarek SM, Mitchell EM, Sjaarda LA, et al. Is Anti-Müllerian Hormone Associated With Fecundability? Findings From the EAGeR Trial. The Journal of Clinical Endocrinology and Metabolism. 2015. https://doi.org/10.1210/jc.2015-2474
Steiner AZ, Pritchard D, Stanczyk FZ, et al. Association Between Biomarkers of Ovarian Reserve and Infertility Among Older Women of Reproductive Age. JAMA. 2017. https://doi.org/10.1001/jama.2017.14588
Aslan K, Kasapoglu I, Kosan B, et al. Age-stratified anti-Müllerian hormone (AMH) nomogram: a comprehensive cohort study including 22.920 women. Frontiers in Endocrinology. 2025. https://doi.org/10.3389/fendo.2025.1612194
Depmann M, Broer SL, Eijkemans MJC, et al. Anti-Müllerian hormone does not predict time to pregnancy: results of a prospective cohort study. Gynecological Endocrinology. 2017. https://doi.org/10.1080/09513590.2017.1306848
Practice Committee of the American Society for Reproductive Medicine. Fertility evaluation of infertile women: a committee opinion. Fertility and Sterility. 2026. https://doi.org/10.1016/j.fertnstert.2026.08.686
Practice Committee of the American Society for Reproductive Medicine. Testing and interpreting measures of ovarian reserve: a committee opinion. Fertility and Sterility. 2020. https://doi.org/10.1016/j.fertnstert.2020.09.134
Broer SL, van Disseldorp J, Broeze KA, et al. Added value of ovarian reserve testing on patient characteristics in the prediction of ovarian response and ongoing pregnancy: an individual patient data approach. Human Reproduction Update. 2013. https://doi.org/10.1093/humupd/dms041
Iliodromiti S, Kelsey TW, Wu O, et al. The predictive accuracy of anti-Müllerian hormone for live birth after assisted conception: a systematic review and meta-analysis of the literature. Human Reproduction Update. 2014. https://doi.org/10.1093/humupd/dmu003
Nelson SM, Pastuszek E, Kloss G, et al. Two new automated, compared with two enzyme-linked immunosorbent, antimüllerian hormone assays. Fertility and Sterility. 2015. https://doi.org/10.1016/j.fertnstert.2015.06.024
Nelson SM, Davis SR, Kalantaridou S, et al. Anti-Müllerian hormone for the diagnosis and prediction of menopause: a systematic review. Human Reproduction Update. 2023. https://doi.org/10.1093/humupd/dmac045
Depmann M, Eijkemans MJ, Broer SL, et al. Does anti-Müllerian hormone predict menopause in the general population? Results of a prospective ongoing cohort study. Human Reproduction. 2016. https://doi.org/10.1093/humrep/dew112
Panay N, Anderson RA, Bennie A, et al. Evidence-based guideline: premature ovarian insufficiency. Human Reproduction Open. 2024. https://doi.org/10.1093/hropen/hoae065
Harlow SD, Gass M, Hall JE, et al. Executive Summary of the Stages of Reproductive Aging Workshop + 10: Addressing the Unfinished Agenda of Staging Reproductive Aging. The Journal of Clinical Endocrinology and Metabolism. 2012. https://doi.org/10.1210/jc.2011-3362
Li HW, Wong BP, Ip WK, et al. Comparative evaluation of three new commercial immunoassays for anti-Müllerian hormone measurement. Human Reproduction. 2016. https://doi.org/10.1093/humrep/dew248
Gracia CR, Shin SS, Prewitt M, et al. 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. https://doi.org/10.1007/s10815-018-1141-5

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