What Does a Low AMH Test Really Mean?
What Is AMH?
Anti-Müllerian Hormone (AMH) is a blood test often used to estimate ovarian reserve, or the number of eggs a woman has left. Unlike other hormone tests, AMH can be checked at any time in the menstrual cycle and tends to give a more stable view of ovarian function. Still, AMH levels can fluctuate from month to month, sometimes by as much as 30%.
Understanding the “Egg Vault” Analogy
Think of your ovaries as a vault. At birth, that vault is full of eggs. Every month, a group of eggs comes out of the vault—one is chosen to ovulate, and the rest die. This process continues whether you are pregnant, on birth control, or simply cycling naturally. Because doctors cannot directly look inside the vault, AMH levels (along with ultrasound-based antral follicle counts) serve as the best available markers for estimating how many eggs remain.
What a Low AMH Means—and Doesn’t Mean
A low AMH result can feel overwhelming, but it’s important to separate fact from fear:
It does not affect natural fertility. Whether you have 5 or 20 eggs available in a given month, your body only needs one to ovulate.
It does not reflect egg quality. Egg quality is determined primarily by age, not AMH.
It does matter for fertility treatments. In IVF or egg freezing, the number of eggs retrieved depends on how many are “outside the vault.” A lower AMH may mean fewer eggs retrieved, which can affect planning.
Factors That Can Lower AMH
Some causes of a persistently low AMH include:
Cigarette smoking and certain environmental toxins
Chemotherapy or radiation exposure
Repeated ovarian surgery (such as for endometriosis or cyst removal)
Autoimmune disease
Family history of early menopause
Temporary decreases may also be seen in women using hormonal contraceptives. In these cases, AMH often improves after stopping the medication.
Why AMH Matters for Family Planning
Even though a low AMH doesn’t directly prevent pregnancy, it can impact:
Timeline for building your family: A lower ovarian reserve may shorten the window of fertility, making it more important to plan ahead if you want multiple children.
Options for fertility preservation: Egg or embryo freezing at a younger age can help preserve fertility potential when ovarian reserve is already low.
What You Can Do
While you cannot control the number of eggs in your vault, you can support egg health and fertility by:
Eating a nutrient-rich, anti-inflammatory diet
Taking antioxidants like CoQ10
Prioritizing sleep and stress management
Avoiding smoking, excessive alcohol, and toxins
And most importantly—seek out a fertility doctor who will advocate for you. If one clinic says “no” to treatment because of your numbers, get another opinion. AMH is just one piece of the fertility puzzle.
The Bottom Line
A low AMH result does not mean infertility. It does not predict egg quality, and it does not change your chances of conceiving naturally in the short term. What it does provide is valuable information about ovarian reserve and family planning options. With the right guidance and proactive choices, women with diminished ovarian reserve can still achieve their fertility goals.
