Anti-Müllerian Hormone Test

What is Anti-Müllerian Hormone?

Anti-Müllerian hormone (AMH; also known as Müllerian Inhibiting Factor) is a chemical messenger that plays a major part in sexual differentiation of the foetus.

In the sexual differentiation of the male foetus, AMH is produced in the testes by Sertoli cells. Its inhibitory effect is responsible for preventing the development of the Müllerian ducts. These ducts are the beginnings of the female internal reproductive organs. AMH levels remain high in males from before birth until puberty.

However, early in sexual differentiation of the female foetus, AMH is not produced in the ovaries. The Müllerian ducts therefore develop into the female internal reproductive organs, namely the fallopian tubes, uterus, and upper part of the vagina.

After birth, AMH is produced by cells within follicles inside the ovaries. These follicles contain immature eggs, and AMH regulates the different stages of folliculogenesis (the series of events that leads to the maturating of an ovarian follicle). Several follicles begin to mature but only one, the dominant follicle, matures and releases an egg each month.

The initial number of follicles is fixed at birth, although they remain dormant until puberty. While dormant, the follicles do not produce AMH. When selected for development, early-stage follicles then produce AMH. AMH levels rise with an increase in the number of growing early-stage follicles, and AMH levels are highest for women in their mid-20s. With increasing age, there is a decrease in number of follicles and, thus, a decline in AMH levels. AMH levels eventually fall to below the level of detection (around zero) at menopause, at about the age of 50 years, when the supply of eggs within the ovaries (the ovarian reserve) is exhausted.

What is an Anti-Müllerian Hormone test?

The AMH test measures the AMH concentration in the blood. A woman’s AMH level can be tested at any time during the menstrual cycle. It has an advantage as a biochemical marker compared to the measurement of other reproductive hormones, as there are no fluctuations with the menstrual cycle.

Why is an Anti-Müllerian Hormone test important?

The AMH test is usually done for women who want to check their reproductive potential. AMH is a reliable evaluator of ovarian reserve, i.e., the egg supply in the ovaries, and estimator of the number of eggs that a woman may produce. It is reliable because AMH determines the number of growing follicles, which is proportional to the size of the initial pool of dormant follicles. Thus, a high AMH level indicates more growing follicles and greater ovarian reserve, while a low AMH level indicates few growing follicles and smaller ovarian reserve.

Who should have their Anti-Müllerian Hormone level tested?

In women, this test is usually used to:

• Estimate the age at which a woman will reach the menopause and, thus, whether she is aging normally and how long she has left to become pregnant.
• Predict the likelihood of becoming pregnant, which is vital for women with infertility concerns.
• Assess the egg supply that could be used for in vitro fertilisation (IVF, a fertility treatment), or for freezing to try having children in the future.
• Predict a woman’s response to fertility medicines, which stimulate the ovaries to produce eggs, trigger egg release, or correct hormone levels, in readiness for IVF treatment.
• Investigate certain conditions causing infertility, such as polycystic ovary syndrome, primary ovarian failure, and ovarian tumours (e.g., granulosa cell tumours).
• Assess the effect of chemotherapy on fertility.

…and for men to:

• Determine their Sertoli cell function, whereby an undetectable or low AMH level can indicate persistent Müllerian duct syndrome (where a man has female reproductive organs), a lack of testicular function, or sex development disorders like undescended testes.

While AMH levels are the most reliable marker of fertility potential, they cannot:

• Be exact about a person’s fertility (either with or without fertility treatments), indicate the quality of the eggs (only quantity), the chance of becoming pregnant, or the time of menopause.
• Assess the effect on fertility of other factors, such as age, smoking, medical conditions, menstrual problems, reproductive organ abnormalities, and sperm viability.

How to test for Anti-Müllerian Hormone?

The AMH test is a home test that requires pricking your finger and collecting a few of the resulting blood drops. A self-collection blood sample pack containing everything that you will need is provided by The Online Clinic. The pack contains full instructions on how to collect the sample, which must be read and followed precisely, and details of where the sample should be sent for laboratory analysis.

Alternatively, blood can be collected by a healthcare professional. This involves using a thin needle to take a sample of blood from a vein in your arm.

All test results will be sent to The Online Clinic, as it is best that we interpret the results and a doctor discusses them with you.

What are normal Anti-Müllerian Hormone test results?

Blood serum level ranges:

• Below 0.5 ng/mL: very low, indicates a significantly reduced ovarian reserve.
• 0.5–1.0 ng/mL: low, indicates a low ovarian reserve; conceiving naturally may be more difficult, and an IVF cycle may yield fewer eggs.
• 1.0–4.0 ng/mL: indicates a healthy ovarian reserve in a fertile woman.
• Above 4.0 ng/mL: high, indicates a high ovarian reserve, although it could also indicate polycystic ovarian syndrome where high AMH levels are due to many small follicles.

A woman’s AMH level naturally declines as she ages, so it is usual to see both a lower AMH level and a lower ovarian reserve in older women. While there is considerable variation between individuals, typical AMH levels are approximately:

• 3.0 ng/mL at 25 years of age
• 2.5 ng/mL at 30 years of age
• 1.5 ng/mL at 35 years of age
• 1.0 ng/mL at 40 years of age
• 0.5 ng/mL at 45 years of age

Note that AMH levels may be temporarily lowered by 20%–30% in women using hormonal contraception.

References

Bernardi LA, Weiss MS, Waldo A, et al. Duration, recency, and type of hormonal contraceptive use and antimüllerian hormone levels. Fertil Steril. 2021;116(1):208-217. doi: 10.1016/j.fertnstert.2021.02.007. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8217153/.

Cleveland Clinic. Anti-Müllerian hormone test. Updated 04 Jul 2022. Available from: https://my.clevelandclinic.org/health/diagnostics/22681-anti-mullerian-hormone-test. Accessed 08 Apr 2026.

di Clemente N, Racine C, Pierre A, et al. Anti-Müllerian Hormone in Female Reproduction. Endocr Rev. 2021;42(6):753-782. doi: 10.1210/endrev/bnab012. Available from: https://pubmed.ncbi.nlm.nih.gov/33851994/.

Patel N, Zafar Gondal A. Embryology, Mullerian-inhibiting Factor. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan–. Available from: https://www.ncbi.nlm.nih.gov/books/NBK544351/. Accessed 08 Apr 2026.