What is AMH?
Anti-Müllerian Hormone (AMH) is a glycoprotein hormone produced by granulosa cells of small antral or pre-antral follicles in the ovaries that can provide an accurate indication as to how many follicles you have left, which is a measurement of your fertility and reproductive capacity. Simply put, it tells your doctor how many eggs you have remaining.
AMH is unlike many other hormones related to fertility because it maintains its levels throughout your menstrual cycle and can be measured at any time during the cycle. This makes it one of the most useful biomarkers for fertility assessments. As such, you don’t have to time your blood test for a specific day in your cycle, which is an advantage over FSH and oestradiol testing.
AMH rises quickly from birth, with peak levels around the age of 25, and then steadily decreases until approximately the time of menopause, when no AMH is retrievable. Research suggests that AMH can be very low about five years before the onset of menopause and, therefore, is a valid marker for assessing early warning signs for menopause.
Understanding what AMH does not tell you is important. The AMH test primarily measures the quantity of eggs available, helping you and your doctor assess your reproductive capacity, but it does not diagnose infertility or determine egg quality. Interpreting your AMH result alongside your age, symptoms, and other tests provides a more complete picture of your fertility potential.
AMH Levels by Age: – what’s considered normal?
AMH levels decrease steadily during your childbearing years, but the speed of this decline can vary greatly between individuals. A large study on AMH results of 22,920 women found a statistically significant negative correlation between age and AMH levels. The median level of AMH was under 1.2 ng/mL by age 36, and the percentage of women with low AMH levels increased from 15.9% at age 18 to 96% at age 45.
The following table provides a general reference point (not an indicator of success or failure) for your AMH result. Hopefully, it assists you in knowing where you stand.
| Age group | Typical AMH range | What this generally suggests |
| Early to mid-20s | 3.0-4.5 ng/mL | Strong ovarian reserve, peak fertility window |
| Late 20s to early 30s | 2.0-3.5 ng/mL | Good reserve, fertility well maintained |
| Mid 30s | 1.0-2.5 ng/mL | Reserve beginning to decline, still favourable |
| Late 30s | 0.5/1.5 ng/mL | Noticeable decline, timely action may be worthwhile |
| Early 40s | 0.2/1.0 ng/mL | Reduced reserve, fertility treatment options worth exploring |
| Mid to late 40s | Below 0.2 ng/mL | Very low reserve, approaching menopause transition |
The median AMH for women aged 25 is around 3.3 ng/mL, decreasing to 1.4 ng/mL by 35 and 0.5 ng/mL by 40. These averages highlight how AMH levels naturally decline with age, but results should always be interpreted in context with your age, symptoms, and clinical history for meaningful insights.
What low AMH means and what it doesn’t
A low AMH level can be frightening, but knowing what it means (and what it doesn’t) can drastically change how to proceed.
A low AMH means there are fewer eggs left than would usually be expected at your age (this is referred to as having a low ovarian reserve). It does not mean that you cannot have children. A cohort study of women between 30 and 44 years of age that examined live birth rates compared women with a low ovarian reserve (AMH < 0.7 ng/mL) to women with a normal ovarian reserve and found no statistical difference in the rate of live births for the two groups. Many women with a low AMH conceive naturally every day.
If your AMH levels are low, that means that your egg supply is likely tapering off at a faster rate than most women, which makes timing the delivery of a baby more important to you. There’s scientific evidence that your ovarian reserve does not affect your probabilities of getting pregnant naturally, as long as the follicles left in your ovaries will allow for regular periods. So if you’re still having regular periods, your ovaries are still producing eggs — and getting pregnant is still possible.
If you get a low score on your AMH test, it gives you information about your fertility; it does not mean that you are infertile. The score on this test is intended to be used by you and your doctor as a springboard to hold an educated discussion about how best to proceed with getting pregnant based on both your AMH score and other fertility-related factors. This score should not make you panic.
What does a high AMH mean
Many people see a high AMH level as being good news, meaning there are more eggs available and the woman has better fertility potential. However, this has a few different connotations and implications depending on the specific use of the term in fertility treatment.
Higher AMH indicates a large number of eggs available to retrieve from a woman’s ovaries during either IVF cycles or while freezing eggs. This gives people who have high AMH levels other professionals hope that ovarian reserve is high before they start trying to become pregnant.
Additionally, many women with high AMH levels also suffer from PCOS (polycystic ovarian syndrome), which can cause increased risk of ovarian hyperstimulation syndrome (OHSS) during fertility treatment; thus, women with high AMH levels> 3.4 ng/ml and high antral follicle counts could potentially have increased risks of OHSS due to the hormonal stimulation of their ovaries. Additionally, the AFSRM guidelines set forth in 2024 recommend that women who have high AMH levels and PCOS be informed of their increased risks and potential strategies to deal with those risks (including use of some type of pre-conception intervention).
In either IVF or the egg freezing process, if there is an over-stimulated response to medications used to stimulate the ovaries in a woman with a very high AMH level, she could develop extremely uncomfortable, swollen ovaries; she could also retain fluid and feel nauseated and/or suffer from serious complications if she developed severe OHSS. Because women with high AMH levels (>3.4 ng/ml) face increased risks for developing OHSS due to the hormones used to stimulate their ovaries during fertility treatment, such women deserve to have individualized, carefully-designed stimulation protocols.
You don’t need to worry about having a high AMH level unnecessarily. Still, if you’re planning to undergo fertility treatment, your clinical team would need to know about this information to develop a protocol for you. The correct method used for the fertility treatments will make the difference in your success.
AMH and IVF: – how it affects treatment planning
Your AMH level plays an important role for your fertility team in designing your IVF protocol, as it gives the only definitive piece of data available at the start of your treatment. It does not tell you whether the treatment will be successful, but it sets how your stimulation will be approached from the beginning.
The primary use of AMH in relation to IVF is to determine the appropriate amount of FSH (follicle-stimulating hormone) that will be required to stimulate the ovaries to produce multiple follicles in preparation for an egg retrieval. By measuring AMH levels, fertility clinics can group patients based on their AMH levels so each group can have an appropriate amount of FSH administered. The goal is to provide a similar, safe number of eggs produced regardless of the AMH level of each patient. On average, the clinics aim to retrieve about 10 oocytes per cycle regardless of individual AMH level.
For women with low AMH, higher starting doses of FSH will typically be needed to maximise the number of oocytes retrievable. Clinical pregnancy rates will still be approximately 27% when women under 35 produce extremely low AMH levels (≤ 0.4 ng/mL) compared to a 41% clinical pregnancy rate when women have AMH levels within a normal range. Thus, having low AMH levels does not preclude younger women from being successfully treated for infertility.
Women with elevated AMH levels will need to receive lower doses of medication and be closely monitored to minimise the risk of OHSS (Ovarian Hyperstimulation Syndrome). The use of AMH-guided dosing algorithms — which are used to determine the FSH dose on the basis of both the individual’s AMH level and their weight — has become common practice in personalising ovarian stimulation and also improves both safety and outcomes.
Your AMH level is used as a tool to help you plan for what to expect; however, it does not predict how successful you will be. Age, egg quality and embryo development remain equally important as AMH, and therefore the clinical team will consider AMH in combination with these other factors, rather than in isolation.
AMH testing in Singapore: – where, cost, and when to test.
| Category | Details |
| What the test involves | A simple blood draw, no fasting, no special preparation required. Because AMH stays stable throughout your cycle, you can book your test on any day without timing it to your period. Results are typically ready within 2 to 7 working days. |
| Private fertility clinics | The fastest and most flexible option. AMH alone costs approximately SGD $100 to $ 160 at private clinics, and is often bundled with FSH, LH, and oestradiol as part of a broader hormone panel with a consultation included. Clinics like Raffles Fertility Centre, Virtus Fertility Centre, and Thomson Fertility Centre offer AMH testing with same-day or next-day appointments. |
| Public hospitals | KKH, SGH, and NUH all offer AMH testing at subsidised rates for Singapore citizens and permanent residents with polyclinic referral. Wait times are longer than in private clinics, but costs are significantly lower, making this the most affordable route if you’re not in a rush. |
| Women’s health and GP clinics | Full female fertility panels, including AMH, FSH, LH, and oestradiol, range from SGD $150 to $350, depending on the clinic and the number of hormones tested. A good option if you want a broader hormonal picture alongside your AMH results without committing to a specialist appointment. |
When to get tested: – An AMH test doesn’t have to be done when you’re attempting to get pregnant. An AMH test can also be a helpful tool when considering egg freezing, if you have irregular periods, if your period doesn’t come on its own, or if you have PCOS, or if you want a more complete understanding of your reproductive future. The sooner you can have an AMH test, the better off you are when it comes time to make a decision.
Frequently Asked Questions
References:
Anti-Müllerian Hormone and Ovarian Reserve: Update on Assessing Ovarian Function—PMC. (n.d.). Retrieved 29 June 2026, from https://pmc.ncbi.nlm.nih.gov/articles/PMC7486884/
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
Can, S., Yang, X., He, Y., Wang, C., Zou, H., Fan, Q., Xu, X., Cai, G., Yunxia, C., & Xiaoqing, P. (2024). Diminished ovarian reserve associates with pregnancy and birth outcomes after IVF: A retrospective cohort study. Human Fertility, 27(1), 2414813. https://doi.org/10.1080/14647273.2024.2414813
Carnesi, E., Castellano, S., Albani, E., Busnelli, A., Smeraldi, A., Bulbul, O., Morenghi, E., Immediata, V., & Levi-Setti, P. E. (2025). Diminished ovarian reserve is associated with euploidy rate: A single-center study. Frontiers in Endocrinology, 15, 1535776. https://doi.org/10.3389/fendo.2024.1535776
Iwase, A., Asada, Y., Sugishita, Y., Osuka, S., Kitajima, M., Kawamura, K., & from the subcommittee “Survey of AMH measurement in Japan” in Reproductive Endocrinology Committee, Japan Society of Obstetrics and Gynecology, 2021-2022. (2024). Anti-Müllerian hormone for screening, diagnosis, evaluation, and prediction: A systematic review and expert opinions. Journal of Obstetrics and Gynaecology Research, 50(1), 15–39. https://doi.org/10.1111/jog.15818
Iwase, A., Hasegawa, Y., Tsukui, Y., Kobayashi, M., Hiraishi, H., Nakazato, T., & Kitahara, Y. (2023). Anti-Müllerian hormone beyond an ovarian reserve marker: The relationship with the physiology and pathology in the life-long follicle development. Frontiers in Endocrinology, 14. https://doi.org/10.3389/fendo.2023.1273966
Klonoff-Cohen, H., Polavarapu, M., & Ramachandran, N. (2025). Anti-Mullerian Hormone and conception timing as predictors of live births in cancer patients using fertility preservation: A systematic review. Frontiers in Oncology, 15. https://doi.org/10.3389/fonc.2025.1683794
Kolcsar, M., Szabó, L., Mihály, R., Vass, E. R., & Gáll, Z. (2024). Anti-Müllerian Hormone Level Determinants among Non-Polycystic-Ovary-Syndrome Women Undergoing In Vitro Fertilization: A Retrospective Cross-Sectional Study. Medicina, 60(9), 1387. https://doi.org/10.3390/medicina60091387
Zhao, M., Huan, Q., Huang, L., Yang, L., & Dong, M. (2023). Pregnancy outcomes of intrauterine insemination in young patients with diminished ovarian reserve: A multicenter cohort study. European Journal of Medical Research, 28, 402. https://doi.org/10.1186/s40001-023-01377-z
Zhu, S., Jiang, W., Liao, X., Sun, Y., Chen, X., & Zheng, B. (2024). Effect of diminished ovarian reserve on the outcome of fresh embryo transfer in IVF/ICSI cycles among young women: A retrospective cohort study. BMC Women’s Health, 24, 230. https://doi.org/10.1186/s12905-024-03039-6
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.
