AMH What you really need to know about this measure of fertility

If you’ve been told your AMH is “too low” or “too high,” you may have left the clinic feeling like hope has been snatched away. I hear this from women all the time. But let me reassure you: AMH is not the full picture of your fertility, and certainly not a verdict on whether you’ll ever become a mum.

What AMH actually measures

Anti-Müllerian Hormone (AMH) is released by the granulosa cells in your ovarian follicles. In simple terms, it reflects how many follicles are growing – but it’s not the end of the novel, there are many more chapters to go from there! And here’s the important bit:

• It does not count your actual eggs.
• It does not measure egg quality.
• And it does not predict your ability to get pregnant naturally.

It was only introduced as a clinical tool around 2002–2004, so a relatively new test, and mainly as a test for IVF clinics to see how women would respond to medication. I’m my opinion 23 years later it is often used a little too bluntly and mostly  to scare women into treatment.

Are we born with all our eggs? Maybe not…

For decades, women have been told: “You’re born with a fixed number of eggs, and they just run out as you age.” But research by Jonathan Tilly and his team in Boston (published in Nature, 2004) suggested otherwise. His work hinted that women may in fact have the ability to generate new eggs from ovarian stem cells.

When I wrote my original blog on this on fertile ground nutrition in 2014 I was often told my medics the above statement was out of context and wrong. In July and August 2025 a few article in the new scientist confirmed this!

This challenges the old narrative that it’s all downhill from 25. It also makes me cautious when I hear sweeping statements about AMH being the “final word” on your fertility.

Why AMH isn’t the whole story

There are so many reasons your AMH can look low,  even if your ovarian reserve is appropriate for your age:

• Coming off the pill or years of hormonal contraception
• Vitamin D or nutrient deficiencies
• Stress and adrenal dysfunction
• Weight changes or metabolic issues

• Hypothalamic amenorrhoea

And studies show that improving reproductive function doesn’t always change AMH. For example, in overweight women with PCOS, fertility improved after weight loss interventions,  but AMH didn’t budge.

So if AMH was truly the golden marker of fertility, why doesn’t it reflect those improvements?

My clinical experience

In my practice, I’ve worked with women told they had “no hope” because of low AMH or high FSH, only for them to go on and conceive naturally. I’ve seen FSH levels as high as 30 brought down with the right nutrition, lifestyle and supplement programmes. I’ve seen “low AMH” clients become pregnant once we reduced stress, restored nutrient reserves, and supported their hormone dance.

Because that’s the point: fertility is not one number on a lab test. It’s an orchestra of hormones, nutrients, lifestyle and emotional health all working together.

AMH, IVF and natural conception

Where AMH can be genuinely useful is in predicting how you might respond to ovarian stimulation in IVF. If it’s low, you may produce fewer eggs on a stimulation protocol; if it’s high, you may be at risk of overstimulation (particularly with PCOS).

But for natural conception? There is no AMH cut-off that says “yes, you’ll conceive” or “no, you won’t.” Women with low and high AMH conceive every day.

Why AMH Isn’t Always Relevant to PCOS or Fertility

• AMH correlates to a hormone given off by development cells in both PCOS and non-PCOS women, making it one measure of fertility but not PCOS itself

• PCOS typically shows elevated AMH (often 2–3 × higher) due to increased follicle numbers, but this varies greatly across different PCOS presentations.

• Different PCOS subtypes (e.g., those with hyperandrogenism vs. just polycystic morphology) exhibit varying AMH levels, undermining its diagnostic reliability.

High AMH Doesn’t Guarantee Better Fertility Outcomes

• Elevated AMH in PCOS signals a potential hyper-response to ovarian stimulation, increasing the risk for complications like OHSS.

• A meta-analysis revealed that PCOS individuals with top-quartile AMH levels actually have lower odds of clinical pregnancy and live birth, compared to those with lower AMH levels.

General Fertility vs. Ovarian Reserve

• While AMH is a useful measure of ovarian reserve, in my view it’s not a dependable predictor of actual fertility or menopause timing.

• Fertility involves multiple factors; oocyte quality, hormonal synchronisation, uterine environment, not captured by AMH alone.

AMH Can Aid PCOS Assessment – but Not in Isolation

• Some sources suggest AMH can help indicate PCOS—especially when paired with other clinical criteria, but its variability means it shouldn’t be used as the sole diagnostic marker.

So what should you do if your AMH is low (or high)?

Instead of panicking, think of AMH as an invitation to dig deeper: what’s driving the imbalance?

Key areas I focus on with clients:

• Nutrition: colourful antioxidant-rich foods, good quality protein from meat and fish, omega-3s, nutrient-dense foods like eggs and salmon roe

• Lifestyle: restorative sleep, moderate movement, stress support, reducing toxins
• Supplements (tailored, not generic): CoQ10 (ubiquinol), vitamin D, omega-3s, sometimes DHEA (medically supervised)

The takeaway

AMH can give us information – but it’s only part of the story. It doesn’t predict your fertility fate. Your body is adaptive, your eggs are dynamic, and with the right support, you absolutely can improve your chances of conception. Just as a caveat – I recently did a Hertility blood test and my AMH came back at 11 (I was 49 at the time) and the more relevant marker was my FSH which was very high and my oestrogen v low, the hormones that build the follicles not the ‘ unbaked muffins’ in the primordial pool! which is what i often describe the AMH as!

In other words;  you are not your numbers.