One of the most alarming test results a woman may see on a lab report is the anti-Müllerian hormone, or AMH.
Most often, the scenario looks the same: you open the result, see a number below the normal range, go to Google – and within ten minutes mentally say goodbye to the possibility of becoming a mother.
Let me say this right away and as calmly as possible: low AMH does not equal infertility. But it should not be ignored either.
In recent years, I have increasingly seen patients aged 28–40 who come to the appointment already frightened. Not by the test itself – but by what they managed to read about it.
The main problem is that too many myths have formed around AMH. It is either dramatized or misinterpreted.
In this article, we will sort it out without extremes:
- what AMH actually shows
- when its decline is a normal age-related variant
- whether pregnancy is possible with a low level
- in which situations delaying truly is not advisable
- and which actions make sense
No intimidation. No false promises. Only clinical logic.
What AMH Actually Shows
AMH is a hormone that reflects ovarian reserve, meaning the supply of eggs in the ovaries.
It is important to understand one key thing:
AMH does not tell you whether you will get pregnant.
It tells you how much time the reproductive system has left.
The follicle supply is formed before birth. New eggs do not appear.
With age, the reserve decreases in everyone – this is biology, not pathology.
Therefore, low AMH by itself is not a diagnosis. It is a marker that helps a doctor predict reproductive potential.
Predict – not deliver a verdict.
Does Low AMH Mean Infertility?
The short medical answer: no.
I regularly see pregnancies in women with AMH below 1.
Why does this happen?
Because AMH:
- does not show egg quality
- does not reflect the presence of ovulation
- does not determine the likelihood of natural conception in a specific cycle
A woman may have a limited follicle supply – and still ovulate.
And only one egg is needed for pregnancy.
Not a thousand.
But there is an important nuance that should be stated honestly.
Low AMH means there is less time for pregnancy planning.
This is not a reason to panic. It is a reason not to postpone decisions indefinitely “for later”.
AMH Levels by Age
A common mistake is comparing your result to an “ideal number from the internet”.
There is no single normal value for AMH. The correct reference point is age.
| Age | Expected AMH Level |
|---|---|
| 20–25 years | 3.0–6.0 ng/mL |
| 25–30 years | 2.5–4.5 ng/mL |
| 30–35 years | 1.5–3.5 ng/mL |
| 35–40 years | 1.0–2.5 ng/mL |
| after 40 | 0.5–1.0 ng/mL |
Important: we evaluate not only the number, but also its correspondence to age.
AMH 1.2 at 29 – a reason to investigate.
AMH 1.2 at 38 – often a normal variant.
Context determines everything.
Is Pregnancy Possible with Low AMH
Yes. And it is not uncommon. But the strategy changes.
If the reserve is declining, we usually do not recommend:
- postponing pregnancy for several years
- relying solely on “whatever happens, happens”
- delaying evaluation
Sometimes it is enough simply not to delay.
Sometimes the support of a reproductive specialist is needed.
But low AMH alone does not close the door to motherhood.
It only suggests that acting consciously is wiser.
It is important to understand that even with low AMH levels, final conclusions are always made in the context of other hormonal parameters. In particular, the FSH level helps clarify whether the body is compensating for a reduced reserve or whether the process has already become irreversible.
When Low AMH Is a Warning Sign
There are situations in which I recommend not postponing a consultation.
Especially if:
- AMH is below 1.0 before age 35
- the level has dropped sharply within 1–2 years
- there is a family history of early menopause
- there have been ovarian surgeries
- pregnancy is planned “not now, but later”
In such cases, panic is not what matters.
Strategy is.
Sometimes the right decision is earlier pregnancy planning.
Sometimes – discussing egg cryopreservation.
The key is that the choice is conscious rather than forced.
A decline in ovarian reserve may be associated with an earlier onset of menopause – I discuss this in detail in a separate article.
What AMH Does NOT Show
This is one of the most important sections that is often overlooked.
| Myth | Reality |
|---|---|
| Low AMH = infertility | Pregnancy is possible |
| AMH shows egg quality | It reflects only their quantity |
| AMH can predict the age of menopause | It cannot be predicted precisely |
| Low AMH means urgent IVF | Management always depends on age and ovulation |
Therefore, diagnoses such as “you have low AMH – urgent IVF” always require a second opinion.
Good reproductive medicine does not operate through intimidation.
Do You Need IVF Urgently?
No. Not always.
The decision depends on three factors:
- age
- ovulation
- overall reproductive picture
For example:
A 32-year-old woman with AMH 0.9 and ovulation present. We often allow time for natural conception.
A 39-year-old woman with AMH 0.6. The strategy will already be different – because the key factor here is age.
The test does not control the decision.
The entire clinical situation does.
Clinical Case
A 33-year-old patient came to the appointment after a routine check-up.
AMH – 0.8.
The lab report marked the result as “low”, and by the time of the consultation she was already convinced that pregnancy was impossible.
The cycle was regular.
Ovulation was confirmed by ultrasound.
FSH – within the normal range.
We discussed the main risk – not current fertility, but the shortening of the reproductive window.
The patient planned pregnancy “in a couple of years”, but after the conversation decided not to postpone it.
Pregnancy occurred naturally within 7 months.
I often recall this case when I see how strongly a single number can frighten someone – and how important it is to interpret it correctly.
What You Can Actually Do If AMH Is Declining
The first and most important thing – do not try to “increase AMH”.
There are no medications that increase the egg supply.
If you are promised otherwise – that is marketing, not medicine.
But you can influence other factors.
It makes sense to:
- avoid postponing pregnancy for many years
- quit smoking – it accelerates follicle loss
- avoid strict calorie-deficient diets
- not push the body into chronic exhaustion
- discuss reproductive plans with your doctor
Sometimes the strongest strategy is making a timely decision rather than waiting for the perfect moment.
Frequently Asked Questions
Is AMH below 1 critical?
Not always. What matters is your age and whether ovulation occurs.
Can AMH be increased?
No. We cannot increase ovarian reserve.
Does low AMH mean early menopause?
Not necessarily. But it may indicate an earlier onset.
Should the test be repeated?
Yes, if the result is borderline or does not match the clinical picture.
If pregnancy is not planned now – what should be done?
The best decision is to discuss a reproductive strategy with your doctor in advance. Sometimes this provides more freedom in the future.
Conclusion
AMH is not an exam you can “fail”. It is a reference point.
It does not determine your ability to become a mother, but it helps you understand how to use your time more wisely.
I always tell my patients the same phrase: what you should fear is not low AMH, but lost time.
Important to Understand
A test alone never establishes a diagnosis.
Reproductive decisions are made based on the full clinical picture – age, ovulation, medical history, and reproductive plans. That is why proper interpretation of AMH is always more important than the number itself.
Calm evaluation, a clear plan, and decisions without haste – this is what a competent approach to reproductive health looks like today. And yes – one number never tells the whole story.
Clinical Guidelines and Sources
- European Society of Human Reproduction and Embryology (ESHRE). Ovarian Reserve Testing Guideline. 2020–2023 update.
- American Society for Reproductive Medicine (ASRM). Testing and Interpreting Measures of Ovarian Reserve: A Committee Opinion. Fertility and Sterility, 2020.
- Broer S.L., Broekmans F.J., Laven J.S., Fauser B.C. Ovarian Reserve Tests: Predicting Fertility and Reproductive Lifespan. Human Reproduction Update.
