What does the AMH test show?
A woman’s egg reserve is established before birth and decreases over the course of life. No new eggs are formed. Anti-Müllerian hormone (AMH) can be used to estimate how large the remaining ovarian reserve is.
AMH is produced by small, growing follicles in the ovaries. In general: the lower the AMH level, the smaller the egg reserve is usually. However, the AMH level does not indicate the quality of the eggs or how likely a spontaneous pregnancy is in a given cycle. For a meaningful assessment, the value is therefore always interpreted together with age and—depending on the question—additional findings.
Anti-Müllerian hormone (AMH) can be measured with a simple blood draw.
Who an AMH test is suitable for
Women trying to conceive
If you are currently trying to conceive or planning to do so, the AMH level can help assess your egg reserve. Together with age, ultrasound findings, and further tests, it is an important component of fertility diagnostics.
DELAYED FAMILY PLANNING
If you are not currently trying to conceive or are postponing family planning to a later time, measuring AMH can be useful. Especially from around age 30, the test can help assess whether the egg reserve is appropriate for your age or already reduced. However, the AMH level does not show egg quality and cannot predict how long pregnancy will still be possible.
ASSESSING OVARIAN RESERVE
Even without a current desire to have children, the AMH level can provide indications as to whether the egg reserve is appropriate for your age or already reduced. It does not measure egg quality and does not allow a direct statement about how likely a spontaneous pregnancy is.
SOCIAL FREEZING
Before social freezing, the AMH level helps assess ovarian reserve and the expected response to hormonal stimulation. Together with age and the number of follicles visible on ultrasound, it is possible to estimate how many eggs can likely be retrieved with stimulation and whether multiple treatment cycles may be necessary to freeze the individually desired number of eggs.
BEFORE IVF OR ICSI TREATMENT
Before IVF or ICSI, the AMH level is one of the important parameters for treatment planning. It helps estimate how the ovaries are likely to respond to hormonal stimulation and supports the individual choice of stimulation dose.
CYCLE DISORDERS & SUSPECTED PCOS
In the case of irregular or absent cycles, measuring AMH can provide additional clues as to the cause. A markedly elevated AMH level may indicate PCOS. For diagnosis, the value is assessed together with the cycle pattern, ultrasound findings, and other hormone levels.
ENDOMETRIOSIS & OVARIAN SURGERY
In cases of endometriosis—especially endometriomas—as well as before or after surgery on the ovaries, measuring AMH can be useful. It helps assess whether ovarian reserve is reduced and may be relevant for further fertility or family planning.
EARLY MENOPAUSE IN THE FAMILY
If your mother or close female relatives entered menopause unusually early, an early assessment of your own egg reserve may be useful. An AMH test can provide indications of reduced ovarian reserve, but it cannot reliably predict the individual timing of menopause.
BEFORE OR AFTER FERTILITY-THREATENING TREATMENTS
Chemotherapy and radiotherapy, as well as certain surgeries, can impair ovarian function and egg reserve. Before such treatment, the AMH level can be part of assessing current ovarian reserve and counselling on fertility preservation. After treatment, it can also be used for reassessment of ovarian reserve.
Medical interpretation of the AMH test
Gold standard
The AMH test is one of the most important markers for assessing egg reserve and a key component of fertility diagnostics. However, on its own it does not answer all questions. The AMH level is most informative when considered together with age, ultrasound findings, and your individual life situation. Only this medical interpretation enables well-founded counselling and supports decisions about the next steps.
Additional tests & options
Additional hormone levels can complement the AMH test and provide information about cycle regulation, follicle maturation, and ovulation. This allows a more comprehensive assessment of the hormonal situation.
Ultrasound can be used to assess the ovaries and the number of small antral follicles (AFC). Together with the AMH level, this enables a more precise assessment of ovarian reserve.
Ultrasound and hormone measurements can be used to examine how follicles mature, how the uterine lining develops, and whether ovulation occurs. This is particularly useful if, in addition to egg reserve, the function of the cycle is also to be assessed.
If family planning is to be postponed to a later time, the AMH level can provide an important basis for counselling on social freezing. Together with age and ultrasound findings, it is possible to estimate how the ovaries are likely to respond to stimulation and how many eggs could be retrieved.
AMH test procedure
From the blood draw to the evaluation of results, the AMH test is straightforward and transparent. You can have the blood draw performed directly at our fertility center. After laboratory analysis, your AMH level is interpreted by a specialist, taking into account your age and individual situation.
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Appointment scheduling
For the AMH test, you can schedule a short appointment at our fertility center. Special preparation or a specific cycle day is usually not required.
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Blood sampling
At your appointment, the blood sample is taken directly on site and takes only a few minutes.
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Analysis in the hormone laboratory
The blood sample is analysed in our in-house hormone laboratory. This is followed by specialist medical interpretation of the AMH level, taking into account your age and individual situation.
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Results report
You will receive the test result promptly by email in digital, encrypted form. If desired, a personal consultation appointment can then be arranged to interpret the results.
Anti-Müllerian hormone too low – what could be the reason?
A low AMH level usually indicates reduced ovarian reserve. The most common cause is increasing age, but egg reserve can also be affected by genetic factors, medical conditions, medical treatments, and certain external influences.
Egg reserve decreases continuously even before birth. Of around 1–2 million eggs at birth, approximately 300,000–500,000 remain at the start of puberty. With increasing age, the number continues to decline. This natural loss occurs mainly through follicle loss (atresia) and not through monthly ovulation. Over the course of reproductive life, there are only about 400–500 ovulations. At the same time, with increasing age, not only the number but also the quality of the eggs decreases.
Genetic factors influence both egg reserve and the age at which ovarian function declines. A family history of premature ovarian insufficiency or very early menopause—especially in your mother or sister—may indicate an increased personal risk.
Certain genetic changes can also be associated with reduced egg reserve and premature ovarian insufficiency. These include, for example, the fragile X premutation and Turner syndrome. In addition, numerous other genes are now known that may be involved in premature impairment of ovarian function. Whether further genetic diagnostics are useful depends, among other things, on age, the extent of reduced egg reserve, and personal and family history.
Surgery on the ovary can reduce ovarian reserve. This applies in particular to the removal of ovarian cysts or parts of an ovary. How strongly egg reserve is affected depends, among other things, on the type and extent of the procedure and the initial situation.
Certain chemotherapies and radiation in the area of the ovaries can damage follicles and significantly reduce ovarian reserve. Before a potentially fertility-threatening treatment, options for fertility preservation should therefore be discussed as early as possible.
Endometriosis—especially endometriomas on the ovaries—can be associated with reduced ovarian reserve. In addition, surgery for endometriomas can further affect egg reserve. If you are trying to conceive or postponing family planning, an early assessment of ovarian reserve may therefore be useful.
Certain systemic and autoimmune diseases can also be associated with reduced ovarian function. Particularly relevant are, for example, diseases of the thyroid or adrenal glands; associations have also been described for conditions such as diabetes, rheumatoid arthritis, Crohn’s disease, or lupus. However, the scientific evidence varies depending on the condition, so a low AMH level should always be assessed in the individual medical context.
Smoking is one of the better-documented modifiable factors. Studies show an association with earlier menopause and impairment of female fertility and ovarian function. Significant exposure to second-hand smoke can also be unfavourable.
Certain environmental chemicals such as bisphenol A (BPA), phthalates, and per- and polyfluoroalkyl substances (PFAS) are being studied for possible effects on ovarian function. There are indications of such associations, but the evidence is not yet conclusive for all substances.
Can AMH levels be improved?
A low AMH level cannot be specifically increased, and an already reduced egg reserve cannot be replenished. However, the measured AMH level can fluctuate and may be higher or lower on repeat testing. This does not mean that new eggs have formed or that the actual egg reserve has increased or decreased accordingly. The key is therefore not to “improve” the AMH level itself, but to interpret it correctly.
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AMH levels can fluctuate
AMH is not a completely constant laboratory value. Biological fluctuations, hormonal influences, and differences between measurement methods can lead to differing results on repeat testing. Especially in the case of unexpected results or values that are unusual for age, a follow-up measurement may therefore be useful.
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Reduce modifiable risk factors
Even if this does not increase the existing egg reserve, it is sensible to reduce modifiable risk factors for ovarian function and fertility as much as possible. This includes, in particular, not smoking and maintaining an overall healthy lifestyle.
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Use dietary supplements selectively
Dietary supplements cannot restore reduced egg reserve. If a nutrient deficiency has been confirmed, targeted supplementation may still be useful. Whether and which preparations are recommended in an individual case should be assessed by a physician.
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In-house hormone laboratory
Your AMH level is measured directly in our own hormone laboratory. This allows us to combine laboratory analysis immediately with the reproductive medicine expertise of our fertility center.
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Specialist medical interpretation
An AMH level alone does not say much. Our reproductive medicine specialists assess the result particularly in relation to your age and individual situation and can recommend further examinations if needed.
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Flexible: on site or from home
You can have the blood draw performed directly at our fertility center in Munich, or order the AMH test conveniently for home and send your blood sample to us for analysis.
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Centrally Located in Munich
Our private center Die Kinderwunschärztin is centrally located between Marienplatz and Stachus and is very easy to reach by public transport.
What Our Patients Say
The blood draw is performed directly at our fertility center. The AMH Basic Check is used to assess your egg reserve and is suitable both if you are trying to conceive and for preventive assessment if you would like to postpone family planning to a later time. You will then receive your result securely and digitally.
Book a consultationNo fixed or flat-rate prices: We bill on the basis of the official scale of fees for doctors (GOÄ). According to the GOÄ, we are not allowed to quote fixed or flat-rate prices for medical services. The prices mentioned are intended to provide orientation and are typical for the treatments mentioned.
Possible VAT liability: Medical services may be subject to VAT (currently 19%). This applies if, after diagnostics have been carried out, no medical indication or confirmed diagnosis is present and it is therefore not a medical treatment in the strict sense. This can be the case in particular with social freezing treatments, but also with the treatment of single moms and same-sex couples.
We would be happy to provide you with detailed cost information for the planned treatment in advance. This allows you to clarify cost coverage with your private health insurance (PKV) as best as possible beforehand. Statutory health insurance (GKV) does not cover costs at our center.
Frequently asked questions about the AMH test
What is an AMH test?
The AMH test measures anti-Müllerian hormone in the blood. The value serves as a marker of ovarian reserve and helps estimate how many follicles are still present in the ovaries. However, it measures neither egg quality nor directly the likelihood of becoming pregnant spontaneously.
When is it useful to have AMH measured?
Measuring AMH can be useful if you are currently trying to conceive or planning to do so, before social freezing, when postponing family planning, before IVF or ICSI treatment, or for certain gynaecological questions. In particular, the value helps assess whether egg reserve is appropriate for your age.
On which cycle day can AMH be measured?
In principle, AMH can be measured on any cycle day. A blood draw at a specific time in the cycle is usually not necessary.
What does a high AMH level mean?
A high AMH level may indicate a high ovarian reserve. However, markedly elevated values can also occur with PCOS. We therefore always assess whether a high AMH level is medically relevant together with age, cycle pattern, ultrasound findings, and other hormone levels.
How quickly does AMH decline?
Over the course of life, AMH tends to decrease as egg reserve declines. However, this pattern varies greatly between individuals and is not uniform. Individual measurements can also fluctuate. A single AMH value therefore cannot reliably predict how quickly egg reserve will continue to decline or when menopause will occur.
Can you get pregnant despite low AMH?
Yes. Even with a low AMH level, a spontaneous pregnancy is very possible. AMH primarily describes egg reserve, but says little about how likely a woman is to become pregnant naturally at the present time. At a comparable age and with otherwise similar conditions, women with low AMH can have similar chances of spontaneous pregnancy as women with normal AMH. The decisive factors are mainly age and thus egg quality, as well as other factors such as ovulation, tubal patency, and semen quality.
Can AMH indicate early menopause?
An AMH level that is markedly low for age may indicate reduced ovarian reserve and thus also be a sign of an increased risk of premature decline in ovarian function. Especially with very low values at a young age, AMH can therefore be an important marker for the risk of premature ovarian insufficiency (POI) or early menopause. However, the individual timing of menopause cannot be reliably predicted based on AMH alone.
How much does the AMH test cost?
The AMH Basic Check at our fertility center costs approximately 87 euros. If additional hormones are to be measured, we offer a more comprehensive fertility test. Medical services are billed in accordance with the German Medical Fee Schedule (GOÄ). Whether costs can be covered by health insurance depends on the medical indication and your individual insurance coverage.
