Low AMH: What It Actually Means (and What It Doesn’t)
A low AMH result tells you roughly how many eggs are left in the queue. It does not tell you how good they are, and it does not predict whether you will get pregnant naturally. What it does predict, and predicts well, is how many eggs one round of IVF or egg freezing is likely to collect.
That is the whole story. The rest of this page explains why the number feels bigger than it is, what can push it down, and what to do with it.
Quick take · screenshot this
Low AMH in 60 seconds
- Do it, it works: read the number next to your age, add a follicle count scan, stop smoking, and if you were on the Pill when tested, retest 3 months after stopping.
- Why not try, it won’t harm: vitamin D if yours is low, CoQ10 if you are heading into IVF, and a healthy scepticism about the lab’s “low” line, which moves from lab to lab.
- Talk to a doctor first: DHEA or anything else sold to “raise AMH”, the timing of egg freezing or IVF, and ovarian surgery, which can lower the number for good.
AMH counts the eggs in the waiting room. It cannot see their faces, and it cannot see your age. You can.
On this page: What the number means · Getting pregnant naturally · IVF and egg freezing · What pushes AMH down · Can you raise it? · What to do next · PMOS (the new name for PCOS), endometriosis, surgery
What does a low AMH result actually mean?
AMH, anti-Müllerian hormone, is made by the small follicles waiting their turn in your ovaries. More waiting follicles, more AMH in the blood. The test is a head count of the reserve, taken from outside. A decent head count. Not an interview.
Two things the number cannot see. Egg quality, which is driven by age and decides whether an egg becomes a healthy pregnancy. And whether you will conceive this year. A woman of 32 with a low AMH still has 32-year-old eggs. A woman of 42 with a glowing AMH still has 42-year-old eggs. The 2026 NICE fertility guideline puts it plainly: use age as the first predictor of your chances, naturally or with IVF.
UK labs report AMH in pmol/L (if yours is in ng/mL, multiply by 7.14). The cut-offs most clinics quote are on the scale below. Under 10 is where most UK clinics call the result low and start talking about timing. Under 5.4 is the older NICE line for a modest response to IVF drugs. The lines shift between laboratories and assays, so a 4.9 at one clinic and a 6.1 at another can be the same ovaries on different days.
And the thing nobody mentions when the result lands in your inbox at 11pm: AMH is a snapshot. It drifts with contraception, smoking, surgery and the test kit used. Useful snapshot. Not a prognosis.
Getting the test. AMH can be taken on any day of the cycle, no fasting. On the NHS it is usually only done once you are under a fertility clinic. Privately, most labs offer it as a single blood test, and home-kit companies bundle it with other hormones. Whoever does it, ask for the result in pmol/L with the lab’s own reference range, and keep the report. The next lab may use a different assay.
Very low AMH. A result under about 1 to 2 pmol/L, or reported as undetectable, means very few follicles are left to count. It still does not say zero, and women do conceive at those levels. What it does change is the conversation: if periods are also becoming irregular or have stopped before 40, FSH and oestradiol are needed to check for premature ovarian insufficiency, and that deserves a specialist appointment soon rather than later.
Can you get pregnant naturally with low AMH?
Yes, and the chances are not meaningfully lower than for women with a normal AMH of the same age. That is not a comforting line written for a website. It is the finding of the best study on the question and, since March 2026, the official position of NICE.
The study followed 750 women aged 30 to 44 trying to conceive, none with a history of infertility (Steiner and colleagues, JAMA, 2017). The 84 women with a low AMH had an 84% predicted chance of conceiving within 12 cycles. The women with a normal AMH had 75%. That gap is chance, not an advantage of low AMH; the point is that there was no meaningful difference either way. The authors concluded that AMH should not be used to judge a woman’s current fertility.
One caveat a careful reader deserves. Those were women with no fertility problem. The study says the number on its own should not frighten you. It does not say that nothing needs looking at if you have already been trying for a while.
NICE guideline NG257, published in March 2026, now tells doctors in one line: do not use AMH to predict pregnancy through natural conception. If someone has told you a low AMH means you cannot conceive on your own, they are working from a belief, not the evidence.
What low AMH does hint at is the length of the runway, not the quality of the plane. Fewer follicles can mean a somewhat earlier menopause, though AMH predicts the timing of that only loosely. It also means that if nothing is happening, waiting the standard year before asking for help is a poorer bet than it is for someone with a large reserve.
What low AMH changes in IVF and egg freezing
Here the number earns its keep, and NICE says so in the same breath: use AMH or an antral follicle count to predict how the ovaries will respond to stimulation, and to counsel people about their chances with assisted conception.
Stimulation drugs can only recruit follicles that are already waiting. Low AMH means fewer of them, so fewer eggs per collection. It does not mean worse eggs. For a young woman that distinction is everything. She may need more cycles to bank the same number of eggs, but each egg carries her age, not her AMH.
Numbers help. A 2025 study of 1,041 egg-thaw cycles worked out how many mature eggs it takes to reach three healthy blastocysts, the point linked to about a 93% chance of a baby. Roughly 15 eggs under 35, 30 at 38 or over, 45 past 40. Low AMH does not move those targets. It changes how many rounds it takes to reach them. “Plan for two cycles” is a very different sentence from “it is too late”, and it is the honest one.
One more guideline point, because clinics still order it: NICE now says FSH should not be used to predict ovarian response or IVF outcome. If a day-2 FSH is the only reserve test you have, ask for AMH and a scan. FSH keeps one job, which is diagnosing premature ovarian insufficiency when periods are failing, not forecasting how IVF will go.
What can cause a low AMH?
Age, mostly. The reserve runs down from before birth and the decline steepens from the mid-30s. But several things press the number down without touching what the ovaries can really do. Check which applies to you before you believe the result.
The Pill figure comes from a Danish study of 887 women: users had an AMH 19% lower and a follicle count 18% lower than non-users of the same age (Birch Petersen, Human Reproduction, 2015). The ovaries are resting, not shrinking, so retest about three months after you come off. The surgery figure is from a meta-analysis of endometrioma operations (Raffi, 2012), and that one does not recover, which is why surgery deserves a fertility conversation first. A family history of menopause before 45 belongs on the list too, as a reason to test sooner.
Lifestyle shapes egg quality and general health. It does not refill the queue. If the internet has told you that stress or coffee lowered your AMH, it has not.
Low AMH result and not sure what applies to you?
A video consultation with Dr Helena Cepparo goes through your history and results and works out what’s worth doing in your case, with a functional approach. If scans, tests or treatment follow, she arranges them herself in central London. One doctor, from your first question onwards.
Can you increase AMH levels?
Not in any way that has been shown to produce more babies. The follicles that make AMH are the ones already waiting; nothing in a capsule adds to the queue.
DHEA and CoQ10 have nudged AMH or egg numbers in small IVF studies of women with a low reserve. Small studies, modest change in the number, no proven change in live births. DHEA is a controlled drug in the UK and needs a prescription and a reason. Vitamin D is worth correcting if you are deficient, for many reasons. Lifting AMH is not one of them.
Chasing the number is the trap. The useful question is not “how do I raise my AMH” but “with this AMH, this age and this timeline, what is the best use of the next twelve months”. That one has real answers.
What to do after a low AMH result
Next steps
Six things that turn a number into a plan
- Put your age next to the result. Under 35 with a low AMH is a timing conversation. Over 38 is an urgency conversation. The number alone is neither.
- Add the scan. An antral follicle count on ultrasound is the other half of the picture, and often steadier than one blood test.
- Check the small print. On the Pill, implant or hormonal coil when tested? Smoking? Recent ovarian surgery? Any of those can make the number read lower than the ovaries deserve.
- Decide what the next two years look like. Trying now, later, or not sure. Low AMH mainly changes the cost of waiting, so this is the question that matters most.
- Already trying? Don’t wait the full year. NICE says anyone with a known factor working against them should be referred to a specialist earlier, not after twelve months, and so should everyone aged 36 or over. A low reserve is a reason to ask for that referral now.
- Test your partner too. A semen analysis takes a week and answers half the question. Fertility is a two-person spreadsheet.
If freezing eggs is on the table, the useful question is how many cycles, not whether. See our egg-freezing guide for the numbers by age.
Low AMH with PMOS, endometriosis or after surgery
PMOS, the new name for PCOS. Polycystic ovary syndrome was renamed polyendocrine metabolic ovarian syndrome in May 2026, and both names will sit on paperwork for a while yet; our PMOS guide explains why. For AMH it is usually the opposite problem. AMH runs high because so many small follicles are stalled, and since 2023 the international guideline lets a high AMH stand in for the ovary scan as one of the three diagnostic features in adults. There is no single number for that: 25 pmol/L is not a PMOS line, the cut-off depends on the assay, and a high AMH on its own never makes the diagnosis. A low AMH in someone told they have PMOS is a reason to revisit the diagnosis, not to panic.
Endometriosis. The disease can lower AMH a little; surgery on an endometrioma lowers it more. If surgery is on the table and children are in your plans, ask for AMH and a follicle count first and talk about freezing eggs. Our endometriosis and fertility guide covers when surgery helps and when it is better left.
After chemotherapy or ovarian surgery. AMH can take a year to settle, and an early result reads lower than the ovaries will manage. Retest before deciding anything on it.
Low AMH is a reason to plan with more care, and sometimes to move sooner. It is not a reason to stop. The women in that JAMA study got pregnant at the same rate as everyone else. They just did not know it when the result arrived.
Low AMH result and not sure what applies to you?
A video consultation with Dr Helena Cepparo goes through your history and results and works out what’s worth doing in your case, with a functional approach. If scans, tests or treatment follow, she arranges them herself in central London. One doctor, from your first question onwards.
Common questions about low AMH
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The questions people type into Google the night the result arrives.
What is a low AMH level in pmol/L?+
Most UK clinics call a result under 10 pmol/L low, and under 5.4 very low. The 5.4 figure is the older NICE threshold for predicting a modest response to IVF drugs. The lines vary between labs and assays, so a result near a cut-off should be repeated and paired with a follicle count scan.
Does low AMH mean I can’t get pregnant naturally?+
No. In the main study on this, women with low AMH conceived at the same rate as women with normal AMH over 12 months. Since 2026 NICE tells doctors not to use AMH to predict natural conception. Age is the better guide.
Can I have low AMH but regular periods?+
Yes, and it is common. Periods stay regular until the reserve is very low, because one follicle a month is all a cycle needs. Regular periods are reassuring about ovulation, not a measure of how many eggs remain.
Does the Pill lower AMH?+
Yes, by about a fifth on average while you take it, and the follicle count on scan drops too. The ovaries are paused rather than depleted, and the number recovers after stopping.
What is the IVF success rate with low AMH?+
Per egg, about the same as for anyone of your age. Per cycle, lower, because fewer eggs are collected. Clinics quote success per cycle, which is why the figures look worse than they are for a younger woman. The practical answer is often more cycles, not poorer odds.
How can I increase my AMH?+
No supplement has been shown to raise AMH in a way that leads to more babies. Stopping smoking and correcting a vitamin D deficiency are sensible anyway. DHEA and CoQ10 have small, mixed studies and need a doctor’s judgement, not a website’s.
References & Scientific Sources
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11 sources, with links to the original papers and guidelines.
- National Institute for Health and Care Excellence. Fertility problems: assessment and treatment. NICE guideline NG257, recommendations 1.18.2 to 1.18.5 (ovarian reserve testing). Published 31 March 2026. www.nice.org.uk/guidance/ng257
- Steiner AZ, Pritchard D, Stanczyk FZ, et al. Association between biomarkers of ovarian reserve and infertility among older women of reproductive age. JAMA. 2017;318:1367-1376. doi:10.1001/jama.2017.14588
- Birch Petersen K, Hvidman HW, Forman JL, et al. Ovarian reserve assessment in users of oral contraception seeking fertility advice on their reproductive lifespan. Hum Reprod. 2015;30:2364-2375. doi:10.1093/humrep/dev197
- Dewailly D, Andersen CY, Balen A, et al. The physiology and clinical utility of anti-Müllerian hormone in women. Hum Reprod Update. 2014;20:370-385. doi:10.1093/humupd/dmt062
- Moolhuijsen LME, Visser JA. Anti-Müllerian hormone and ovarian reserve: update on assessing ovarian function. J Clin Endocrinol Metab. 2020;105:3361-3373. doi:10.1210/clinem/dgaa513
- La Marca A, Sighinolfi G, Radi D, et al. Anti-Müllerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART). Hum Reprod Update. 2010;16:113-130. doi:10.1093/humupd/dmp036
- Tal R, Seifer DB. Ovarian reserve testing: a user’s guide. Am J Obstet Gynecol. 2017;217:129-140. doi:10.1016/j.ajog.2017.02.027
- Namath A, et al. Number of mature oocytes needed to achieve euploid blastocysts by age: an analysis of 1,041 oocyte-thaw cycles. Fertil Steril. 2025;124:487-495. PMID 40280226
- Plante BJ, Cooper GS, Baird DD, Steiner AZ. The impact of smoking on antimüllerian hormone levels in women aged 38 to 50 years. Menopause. 2010;17:571-576. doi:10.1097/gme.0b013e3181c7deba
- Raffi F, Metwally M, Amer S. The impact of excision of ovarian endometrioma on ovarian reserve: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2012;97:3146-3154. doi:10.1210/jc.2012-1558
- Teede HJ, Tay CT, Laven J, et al. Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Eur J Endocrinol. 2023;189:G43-G64. doi:10.1093/ejendo/lvad096
