Summary

This test measures anti-Mullerian hormone (AMH) in the blood. It is used along with other hormone tests such as oestradiol, progesterone and FSH to assess the ability to produce eggs that can be fertilised for pregnancy.

A lower level of AMH indicates there are fewer eggs remaining. AMH levels gradually decline as a woman ages, and as the number of eggs decreases. This has implications for her ability to become pregnant and her likely responsiveness to in vitro fertilisation (IVF) treatment.

Although AMH level can be useful in assessing your remaining egg reserve and the number of fertile years you may have left it cannot predict IVF success. It does not measure the quality of the remaining eggs but the quantity of your ovarian reserve appropriate for your age.

You can still become pregnant with fewer eggs or have more eggs but not be able to become pregnant. Fertility declines with age, and it is not possible to predict the rate of decline for an individual.

Measuring AMH is most useful in predicting the number of eggs that may be obtained from a cycle in IVF treatment.  

AMH is also one of several tests used to evaluate new-born babies who are not clearly male or female due to underdevelopment of their external sex organs.

Why get tested?

AMH is a hormone produced by reproductive tissues including egg follicles. A follicle is a small sac of fluid in the ovaries that contains the developing egg.

Levels of AMH in the blood correspond with the number of egg follicles. It is known that women with lower AMH levels produce lower numbers of eggs compared with women with higher AMH levels.

The total number of healthy, immature eggs in the ovaries is called the ovarian reserve. A woman is born with a lifetime supply of eggs. At birth, she has about one million eggs which decreases naturally during childhood to about 500,000. Only a small number of these remaining eggs will go through follicle maturation - one at a time as part of her monthly menstrual cycle.

AMH is made in the ovaries.

AMH declines over time during childbearing years, drops significantly as menopause approaches, and typically becomes almost undetectable after menopause.

Although it has been suggested in several studies that measuring AMH   can help predict the onset of menopause, the use of AMH testing for this purpose is not recommended.  There is no simple test to predict or confirm menopause or perimenopause.

It has also been suggested that AMH may be useful in assessing polycystic ovary syndrome (PCOS) and premature ovarian failure. PCOS is a hormonal condition associated with irregular menstrual cycles, facial and body hair growth, obesity and reduced fertility.

Studies have shown that women with PCOS may have an AMH level up to four times the normal level for their age.  However, AMH levels are not accepted as part of the diagnostic criteria for PCOS.

Having the test

Sample

Blood
Any preparation?

None

Your results

Reading your test report

Your results will be presented along with those of your other tests on the same form. You will see separate columns or lines for each of these tests.
AMH can be measured on any day of the menstrual cycle and does not vary from one cycle to another cycle. This is one of the reasons why many infertility specialists use AMH to check ovarian reserve.
There is substantial AMH test result variations between pathology laboratories and doctors should be familiar with the test used and reference interval of their chosen laboratory. If you are tracking your levels, it is best to use the same laboratory to avoid fluctuations in the results.   

Women with cancer

Chemotherapy and radiation therapy for cancer can damage the ovarian reserves. Testing AMH levels before treatment can be useful in predicting the long-term loss of ovarian function during treatment. Levels may indicate that freezing eggs could be helpful in preserving fertility.

Infants

In a male infant, no or low levels of AMH may point to a problem with the AMH gene that directs AMH production. This may be seen with absent or dysfunctional testicles. Lack of male hormones may result in ambiguous genitalia and may cause abnormal internal reproductive structures. Normal levels of AMH and androgens in a male infant whose testicles have not descended indicate that they are present and functional but not physically located where they are supposed to be.

Reference intervals

Your results will be compared to reference intervals (sometimes called a normal range).

• Reference intervals are the range of results expected in healthy people. 
• When compared against them your results may be flagged high or low if they sit outside this range.
• Many reference intervals vary between labs so only those that are standardised or harmonised across most laboratories are given on this website.

If your results are flagged as high or low this does not necessarily mean that anything is wrong. It depends on your personal situation. Your results need to be interpreted by your doctor.

Questions to ask your doctor

The choice of tests your doctor makes will be based on your medical history and symptoms. It is important that you tell them everything you think might help.
You play a central role in making sure your test results are accurate. Do everything you can to make sure the information you provide is correct and follow instructions closely.
Talk to your doctor about any medications you are taking. Find out if you need to fast or stop any particular foods or supplements. These may affect your results. Ask:

• Why does this test need to be done?
• Do I need to prepare (such as fast or avoid medications) for the sample collection?
• Will an abnormal result mean I need further tests?
• How could it change the course of my care?
• What will happen next, after the test?

Any more to know?

For most women the AMH test is not considered necessary unless they are having fertility issues. The AMH test is most useful when assessing someone for IVF treatment.
The test is a specialist test requiring sophisticated instrumentation and must be performed in a pathology laboratory. Your blood sample may need to be sent to a reference laboratory.

More information

Pathology and diagnostic imaging reports can be added to your My Health Record.

You and your healthcare provider can now access your results whenever and wherever needed. Get further trustworthy health information and advice from healthdirect.