The AMH test measures the number of eggs left in your ovaries; it doesn’t assess egg quality or predict whether you can get pregnant naturally. A low AMH value is not a diagnosis of infertility. These are the four most important things to understand before you read your AMH result, and almost nobody explains them clearly enough before the number is in front of you.
What AMH Is and What It Measures
AMH, or Anti-Müllerian Hormone, is made by the granulosa cells in the small follicles of your ovaries. If you have more follicles, your ovaries make more AMH. This means your AMH level gives you a good idea of your ovarian reserve, or how many eggs you have left.
Most fertility hormones change during your cycle, but AMH stays steady. You can check your AMH any day, at any time, and you don’t need to fast. This makes AMH one of the easiest and most convenient fertility tests.
Your AMH level rises from birth and peaks around age 25. After that, it slowly drops until it is no longer detectable at menopause. Studies show that AMH starts to fall more quickly about five years before menopause. This makes AMH a helpful early sign that your body is starting the transition to menopause.
AMH Ranges By Age
| Age | Expected AMH (ng/mL) | Expected AMH (pmol/L) | What is suggests |
| Early to mid-20s | 3.0 – 4.5 | 21.4 – 32.1 | Strong ovarian reserve; peak fertility window |
| Late 20s to early 30s | 2.0 – 3.5 | 14.3 – 25.0 | Good reserve; fertility well maintained |
| Mid-30s | 1.0 – 2.5 | 7.1 – 17.9 | Reserve beginning to decline; still favourable |
| Late 30s | 0.5 – 1.5 | 3.6 – 10.7 | Noticeable decline; timely action worthwhile |
| Early 40s | 0.2 – 1.0 | 1.4 – 7.1 | Reduced reserve; fertility treatment worth exploring |
| Mid to late 40s | Below 0.2 | Below 1.4 | Very low reserve; approaching menopausal transition |
Units ng/mL vs pmol/L and How to Convert
You may see your AMH results reported in two different units: ng/mL (nanograms per millilitre) or pmol/L (picomoles per litre). Many labs in Singapore use pmol/L, while most online reference ranges use ng/mL. This can be confusing, but you can easily convert between them.
To convert your result, multiply the ng/mL value by 7.14 to get pmol/L. Or, divide pmol/L by 7.14 to get ng/mL.
For example, if your AMH is 2.0 ng/mL, that equals 14.3 pmol/L. Always check which unit your lab uses before you compare your result to a reference range.
A low AMH means your ovarian reserve is lower than average for your age. You have fewer eggs left. That is all this test tells you directly.
Here is what a low AMH does NOT mean:
1. It does not mean you cannot conceive naturally.
A 2024 study of 3,150 women found that those with low AMH (below 1 ng/mL) had a lower, but not zero, chance of natural conception. About 11% became pregnant per cycle, compared to 14% with normal AMH. Women with low AMH conceive naturally every day. Another 2024 study confirmed that if you still ovulate regularly, your ovarian reserve doesn’t affect your chance of conceiving naturally.
2.It does not mean your eggs are poor quality.
AMH reflects egg quantity only. Egg quality depends mostly on your age, not your AMH level. For example, if you are 30 with low AMH, your egg quality is better than someone who is 42 with normal AMH.
3.It does not mean IVF will not work.
Current evidence shows that even with very low AMH, you can still have a reasonable chance of pregnancy and live birth. Low AMH alone is not a reason to avoid or be denied fertility treatment.
4.It does not mean you are in menopause.
If you have low AMH in your 30s or early 40s, this means you have fewer eggs, not that you are in menopause. Menopause is only confirmed after you have gone 12 months without a period.
What a High AMH Means
Link to PCOS
If your AMH is high, especially above 3.5 ng/mL after age 35 or above 5.0 ng/mL at any age, it is often linked to PCOS. This means you may have more small follicles than average. Each of these follicles produces AMH, so your levels increase. In this case, high AMH reflects how your ovaries look, not necessarily better fertility.
A high AMH result is not always good news if you are considering fertility treatment. If your AMH is very high, you have a higher risk of ovarian hyperstimulation syndrome (OHSS) during IVF. This means you will need a carefully tailored treatment plan. Always talk to your specialist about your AMH before starting any fertility treatment.
What AMH Cannot Tell You: Be Clear About This
AMH is a valuable test in reproductive medicine, but it is often misunderstood. Here is what your AMH result cannot tell you:
Your AMH result cannot tell you about your egg quality. Egg quality depends on your age and the chromosomes in your eggs, not your AMH level.
AMH cannot predict if you will get pregnant. It only shows how your ovaries might respond to stimulation, not whether you will conceive. Some people with low AMH conceive naturally or with treatment, while others with normal AMH may not.
A low AMH result does not mean you are infertile. It is not a diagnosis. Instead, it is a sign to look more closely and, if needed, take action sooner.
AMH cannot predict your risk of miscarriage. Research shows that AMH does not help predict miscarriage in natural conception. Most miscarriages happen because of chromosomal problems in the embryo, which are linked to egg quality, not the number of eggs.
AMH alone cannot confirm or rule out perimenopause. Always consider your AMH result alongside your symptoms, menstrual history, FSH, and oestradiol levels. Never rely on AMH alone.
AMH and Egg Freezing: How It Shapes Expected Egg Yield
AMH is the most important test you will have before starting an egg-freezing cycle. It helps you understand how your ovaries may respond to stimulation and sets clear expectations for how many eggs you might retrieve.
Here is what your AMH level can mean for you. If your AMH is above 1.5 ng/mL, you are likely to respond well and may retrieve 10 or more eggs in one cycle. If your AMH is between 0.5 and 1.5 ng/mL, you might retrieve 5 to 10 eggs per cycle. You may need more than one cycle to reach your goal. If your AMH is below 0.5 ng/mL, you may retrieve fewer eggs, and results can be less predictable. However, egg freezing can still be worthwhile, especially if you are younger.
If you freeze 15 to 20 mature eggs before age 38, your chance of having a baby later is over 70%. This is why the timing of egg freezing, guided by your AMH, really matters. An antral follicle count ultrasound, together with your AMH, gives you the clearest idea of what to expect.
AMH and IVF: How Clinics Use It for Protocol and Dosing
At the start of IVF, your AMH level helps the clinic decide your initial FSH dose. The initial FSH dose is a hormonal drug that signals your ovaries to grow several follicles at once. The aim is to help you produce a safe, steady number of eggs, generally 8 to 15, regardless of your AMH level.
If your AMH is low, your clinic will usually start you on a higher dose to help you get more eggs. If your AMH is high, especially if you have PCOS, you will likely get a lower dose and closer monitoring to lower your risk of OHSS. Most clinics now use AMH-guided dosing as standard IVF practice. Your AMH result does not predict if IVF will work for you, but it is the key factor in planning your stimulation.
When and How to Test
Cycle Timing
You can test your AMH at any point in your cycle. There is no need to fast. Most labs in Singapore will give you your results within 2 to 7 working days.
Effect of Hormonal Birth Control
If you use hormonal contraception, such as the pill, mini pill, implant, or hormonal IUD, your AMH levels may be lower while you are on it. Research shows that current users can have about 41.5% lower AMH than those who have never used these methods. Your AMH usually returns to normal a few months after you stop. If you want the most accurate results, talk to your doctor about whether to test now or after stopping your contraception. Interpret your results with this in mind.
AMH Test Cost in Singapore and Where to Get It
You can get an AMH test in Singapore without a referral. Most private GP clinics, fertility clinics, and health screening labs offer this service.
Provider type Estimated cost (SGD)
Health screening labs (e.g., ATA Medical) SGD $80.50 – $100
Private GP clinics SGD $100 – $160
Private fertility clinics SGD $120 – $180
Public hospitals (subsidised, with referral) Lower; confirm directly with clinic.
Results are usually discussed with a doctor who considers your age, symptoms, and fertility goals when interpreting the figures, rather hanrather than looking at them in isolation. You can’t take action based on a number without clinical context.
What to Do About a Low Result
A low AMH result gives you information. It is not a verdict. Here is what you can do next:
You should see a fertility specialist as soon as possible since the more options open up the earlier you are assessed. It might be possible for you to freeze your eggs, begin IVF, or keep an eye on your fertility before your reserves drop any further.
If you’re not ready to proceed with conception, then it’s best to freeze your eggs as soon as possible. It is better to freeze your eggs while your AMH level is still detectable if you want to maximise the number of viable eggs you will have for later use.
Consider the lifestyle changes that are possible for you. Smoking is associated with lower AMH levels. A large study from 2026 involving more than 16,000 women showed that both smoking and vaping can lead to a reduction in AMH. If you are overweight, following a pro-fertility diet might help raise your AMH. Although most studies indicate that vitamin D supplements do not directly increase AMH, addressing a deficiency supports your overall reproductive health.
Don’t panic. A low AMH level doesn’t mean you can’t have a child; it just means you should take appropriate action promptly.
Frequently Asked Questions
References:
- Aslan, K., Kasapoglu, I., Kosan, B., Tunali, A., Tellioglu, I., & Uncu, G. (2025). Age-stratified anti-Müllerian hormone (AMH) nomogram: A comprehensive cohort study including 22.920 women. Frontiers in Endocrinology, 16, 1612194. https://doi.org/10.3389/fendo.2025.1612194
- Galati, G., Reschini, M., Chine’, A., Benaglia, L., Vigano’, P., Somigliana, E., Vercellini, P., & Muzii, L. (2024). Ovarian reserve does not influence natural conception: Insights from infertile women. Archives of Gynaecology and Obstetrics, 310(5), 2691–2696. https://doi.org/10.1007/s00404-024-07741-6
- Getreu, N., Wainwright, E., Crawford, L., Nedelcu, S., Dhonnabháin, B. N., Vaz, S. R., Vasavan, T., & O’Neill, H. C. (2026). E-cigarette use (vaping) and cigarette smoking are associated with reduced markers of ovarian reserve: A cross-sectional study of 16,087 women. BMC Women’s Health, 26(1), 437. https://doi.org/10.1186/s12905-026-04620-x
- Nelson, S. M., Shaw, M., Ewing, B. J., McLean, K., Vechery, A., & Briggs, S. F. (2024). Antimüllerian hormone levels are associated with time to pregnancy in a cohort study of 3,150 women. Fertility and Sterility, 122(6), 1114–1123. https://doi.org/10.1016/j.fertnstert.2024.06.024
- Weghofer, A., Dietrich, W., Barad, D. H., & Gleicher, N. (2011). Live birth chances in women with extremely low-serum anti-Mullerian hormone levels. Human Reproduction, 26(7), 1905–1909. https://doi.org/10.1093/humrep/der134
- Werner, L., Verschuren, W. M., Picavet, H. S. J., Broekmans, F., van der Schouw, Y. T., & de Kat, A. C. (2026). Exploring the association between lifestyle factors and anti-Müllerian hormone concentration and rate of decline. Reproductive Biomedicine Online, 53(1), 105432. https://doi.org/10.1016/j.rbmo.2025.105432
Anna Haotanto is the Founder of Zora Health and a passionate advocate for women’s empowerment. Anna’s personal experiences with egg-freezing, PCOS, perimenopause and the challenges of fertility have fueled her mission to provide high-quality information, financing, and support to help women and couples navigate their fertility journeys with confidence. She is also recognised for her achievements in finance, entrepreneurship, and women’s empowerment, and has been featured in various media outlets. You can also follow her on Linkedin or Instagram.
