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Low AMH Levels: What Do They Really Mean For Fertility?

Sarah Abernathy - Certified Herbalist
July 26, 2021
Reviewed by Christine Traxler, MD

Women often reach out to us concerned when tests reveal they have low levels of Anti-Mullerian Hormone (AMH). But what does this test really mean and are AMH tests reliable? New research suggests AMH test interpretation may need updating. Additionally, your lifestyle, where you are at in your menstrual cycle, and other factors can affect your AMH levels. While knowing your AMH levels is important if you are struggling with infertility, a single AMH test does not reveal your whole fertility-health picture.

AMH testing is part of the gold standard for modern fertility tests. AMH is a protein produced by cells in ovarian follicles. AMH testing developed in 1990 after research on women undergoing IVF found a positive correlation between AMH levels and the number of eggs retrieved after ovarian stimulation.

Most fertility doctors now believe that low AMH levels by themselves should not exclude a woman as a good candidate for IVF. In some cases, women with low AMH levels may have reduced egg quantity (ovarian reserve), but still have good egg quality and a good chance for a healthy pregnancy.

AMH by the Numbers

  • Normal AMH levels (1.5 to 4.0 ng/ml) are associated with increased fertility and better response rates to fertility treatments.
  • Low–Normal AMH levels (1.0 to 1.5 ng/ml) are associated with decreased ovarian reserve but chances can still be good for pregnancy outcomes.
  • Very low AMH levels (below .5 ng/ml) suggest diminished ovarian reserve and fertility concerns.

What affects AMH levels?

AMH levels are regulated by gonadotropin hormone, and are the highest during the early stages of follicle development (when the follicle measures less than 4 mm). AMH production stops or slows down as a follicle grows larger. Some research finds there is almost no AMH production when follicles reach 8mm.

Natural fluctuations in circulating AMH levels are critical to our understanding of what they mean in relation to fertility. They also reveal the potential limitation of interpreting a single measurement of AMH in relation to egg quantity or egg quality. In fact, serial measurements of AMH, along with other biomarkers such as FSH and Inhibin-B may provide useful information, but a single value is almost meaningless.

Low AMH Levels

Aging is the primary reason for low AMH levels. Early ovarian aging due to stress, poor food choices, low circulation to the ovaries, hormonal imbalance, illness, injury, genetic factors, autoimmune disorders and even lifestyle factors (shared in detail below) can all impact AMH levels and ovarian function.

Low AMH levels in younger women (35 and under) can signal they are at risk for early menopause but his has not been substantiated conclusively in longitudinal studies. In these situations, natural and/or medical measures may be needed to help preserve and enhance fertility. Family history of early menopause and other genetic factors play a significant role and consideration for testing in high risk women may prove beneficial.

What about High AMH Levels?

Research out of Brigham and Women’s Hospital and Harvard Medical School links high AMH levels to increased breast cancer risk in premenopausal women. High AMH levels (over 4 ng/ml) can also be a sign of PCOS. Women with PCOS often have many small follicles (cysts) and therefore test high in AMH. If this sounds like you, be aware that women with high AMH levels are at a greater risk for OHSS (ovarian hyper-stimulation syndrome) if they pursue medical fertility treatments. Work with your doctor to reduce your risk factors if you’re concerned. PCOS and higher AMH levels lead to increase chance of pregnancy and live births, according to one 2014 study published in the American Journal of Obstetrics & Gynecology that evaluated IVF outcomes.

AMH & Menopause: AMH levels decline naturally with age. Women in menopause typically have low AMH (see previous list) and high follicle stimulating hormone (FSH) levels (above 15) on day 3 of their cycle. This is a normal change we see as the reproductive years come to a close.

Can Lifestyle Factors Impact AMH levels?

Yes! Excessive exposure to toxins can affect ovarian reserve and decrease your AMH levels.

  • Heavy smoking (20 plus cigarettes a day) is linked to low AMH levels and early menopause (Fertility and Sterility).
  • Long-term exposure to sources of environmental smoke, like that from indoor heating (artificial fire logs, burning wood at least 10 times a year), is linked to low AMH levels in recent tests.
  • Drug treatments like chemotherapy can cause AMH and ovarian reserve to drop significantly. If you have cancer, ask your doctor about fertility sparing options that may be available.

Hope for the Future

If you have tested low in AMH and are worried, please keep in mind that a single AMH test does not offer a complete view of your fertility. New testing approaches for AMH levels may evolve that offer more insight, particularly for healthy, young women with low AMH where current tests may be unreliable. Using natural methods like charting your cycle and monitoring cervical mucus can also give you more information on your fertility cycle.

Additionally, following a natural Egg Health Program and using fertility herbs can provide benefits to your egg health and may help support normal AMH levels. We encourage you to pursue follow up testing to see if your AMH or egg health changes over time with natural or medical therapies.

Explore all of your options and don’t give up hope after one test. In many cases, women with a low AMH level may go on to have successful pregnancies, particularly if they don’t have other fertility concerns.

While exploring your options, here are three resources to help you learn more about AMH in relation to fertility health:
AMH, Ovarian Reserve, & Continued Follicle Production
Fertility Q&A Part 1: The Chance of Natural Conception with Low AMH Levels
Fertility Q&A Part 2: The Chance of Natural Conception with Low AMH Levels

References

  • White, A., Sandler D., D’Alosio, A. (2016, Sept.). Antimüllerian hormone in relation to tobacco and marijuana use and sources of indoor heating/cooking. Fertility and Sterility. Retrieved from: http://www.fertstert.org/article/S0015-0282(16)61282-7/fulltext
  • Anderson, R. (2016, Oct.). Towards improving analysis and interpretation of antimüllerian hormone in women. Fertility and Sterility. Retrieved from: http://www.fertstert.org/article/S0015-0282(16)61392-4/fulltext
  • Sherbahn, R. (2016). Anti-Mullerian Hormone Testing of Ovarian Reserve. Retrieved from: http://www.advancedfertility.com/amh-fertility-test.htm
  • AMH (Anti-Mullerian Hormone): What is AMH and What Does It Mean For Your Fertility (2016). Retrieved from: https://www.createhealth.org/fertility-treatments-services/fertility-diagnosis/amh
  • Faye, S. (2014). Anti-Mullerian Hormone and Its Significance in Women’s Fertility. Retrieved from: http://www.mlo-online.com/anti-mllerian-hormone-amh-and-its-significance-in-womens-fertility.php
  • Tal R, Seifer DB, Khanimov M, Malter HE, Grazi RV, Leader B. (2014 Jul). Characterization of women with elevated antimüllerian hormone levels (AMH): correlation of AMH with polycystic. 211(1):59.e1-8. doi: 10.1016/j.ajog.2014.02.026. Epub 2014 Mar 2. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/24593938
  • Eliassen AH, Zeleniuch-Jacquotte A, Rosner B, Hankinson SE. (2016, May). Plasma Anti-Müllerian Hormone Concentrations and Risk of Breast Cancer among Premenopausal Women in the Nurses’ Health Studies. Cancer Epidemiology. 25(5):854-60. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26961996

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About the Author

Sarah Abernathy - Certified Herbalist

Sarah has worked in the field of natural foods and herbalism for over 20 years. She's the Co-Author of "Healthy Healing" with over 1 million copies sold, a Certified Herbalist, and a health and wellness consultant. Sarah Graduated from the Professional Herbal Studies program at East West School of Herbology, and holds a Bachelor’s Degree in English from St. Mary's College. Working with women on their journey to wellness is her passion and she loves to share what she has been blessed to learn from naturopaths and other herbalists over the years.

5 Steps To Improve Your Fertility Naturally

  • Learn the 5 different areas to focus on for optimal fertility health
  • Learn how to support hormonal health with herbs and essential oils
  • Tips on transitioning to a whole food fertility diet.
  • Self-care therapies to support your reproductive health

@NaturalFertilityInfo

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🥚 In the past, a common belief was that the only factor which determines ovarian and egg health was age. 

Based on new studies, we now know that this may not be true. 🤯

There are many factors that can have an impact on the health of the ovaries and eggs including environmental factors, hormones in the diet, and stress, just to name a few.

In addition, having healthy fertility is based on many additional aspects to consider, including:
➡️ Proper circulation
➡️ A healthy fertility cycle
➡️ Balanced hormones
➡️ Healthy eggs

Egg health is one of the cornerstones of healthy fertility. 

The health of your eggs (ova) can affect whether or not fertilization and implantation will occur as well as the viability of a pregnancy.

During the cycle of an egg’s journey towards ovulation, there is a window of opportunity, a period of time, when certain factors can affect the health of the eggs that are preparing for ovulation. ⏳

This journey takes about 90 days. 

The steps you take today will impact the health of your eggs 3 months from now. 

That is why I talk so much about taking a MINIMUM of 90 days to prepare for pregnancy or IVF/IUI. 

🙂 The good news is that there are steps you can take to help support the health of your eggs. There is too much info to put into this tiny caption but….

Type EGG if you would like me to send you my Egg Health Checklist that takes you through all of the steps to take.👇👇

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3️⃣ Protect and remove any substances that are causing harm

4️⃣ Learn how to fertility chart and read your monthly cycle

5️⃣ Add lifestyle habits that help to support fertility health

🌼 To learn more on how to support your fertility naturally, type STEPS in the comments below to join my free mini-course - 5 Steps To Improve Your Fertility Naturally, where I go into detail on each of the 5 steps. 👇

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Fertility Cleansing for men is a big step in the right direction. 

👇 To learn more about the Fertility Cleansing type CLEANSE in the comments below and I will send you my Guide To Fertility Cleansing. 👇 

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Nutrition can make a big difference when you are wanting to prepare for pregnancy, support hormonal health or overcome fertility issues.

But it can sometimes be hard to start new habits.

One of my favorite ways to make lasting dietary changes is to focus on what you can add instead of only the things you shouldn’t be eating.

There are 5 specific things I have my clients add to their current diets every day.

🍌What they found after about 21 days of eating this way, they started to not only crave healthier foods, their body was giving them positive feedback through lighter cycles, better digestion, clearer skin and more energy. ⚡

While eating healthy is something you will need to do for the rest of your life, doing a challenge like this helps to give you a great jump start.

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Ready to get started? 

👇 Type CLEANSE in the comments below and I'll send you my Guide To Fertility Cleansing. 💪 

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🌱Learn how to balance your HORMONES naturally 👇

Here are 3 practical and affect ways to support your hormonal health.

One of the keys to see the best results is to stay consistent and learn as much about your body as you can.

1️⃣ Use liver supporting herbs

Herbs such as milk thistle have been shown to help the liver in it's natural ability to get rid of toxins and chemicals in the body.

This can make a big difference when it comes to hormone balance.

2️⃣ Do the Fertility Cleanse 1-2x per year

Support the body in it’s natural ability to get rid of excess hormones by doing a fertility cleanse.

3️⃣ Stop using skin care and cleaning products that contain hormone mimicking chemicals

Xenohormones mimic estrogen in the body and can cause imbalance.

👇 To learn more about the Fertility Cleansing type CLEANSE in the comments below and I will send you my Guide To Fertility Cleansing. 👇

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Should men do a Fertility Cleanse as well? 💪

A common misconception when it comes to fertility is that if there is an issue it is most likely going to be with the woman. 

This is simply not true. 

Statically fertility issues impact men just as often as women and lifestyle factors can make a big difference. 

The Male Fertility Cleanse Kit helps to support men to cleanse and detox excess hormones, toxins, increase circulation and promote hormone balance. 

👇 Drop MEN in the comments below & I will send you my Male Fertility Checklist with all the details on which herbs, supplements and foods to focus on in addition to cleansing 👇

#malefertilty #naturalfertility #gettingpregnant #fertilitytips

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Get ready to prep your body for conception with Fertility Cleansing 101 🌿

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By cleansing the uterus and liver through the use of herbs, you'll be supporting your body in preparation for conception. 

The Fertility Cleanse encourages the liver to cleanse the body of toxins and excess hormones, while also supporting the uterus in cleansing old stagnant blood and increasing circulation.

Ready to get started? 

👇 Type CLEANSE in the comments below and I'll send you my Guide To Fertility Cleansing. 💪 

#FertilityJourney #ReproductiveHealth #Cleansing"

naturalfertilityinfo

View

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Get ready to prep your body for conception with Fertility Cleansing 101 🌿

The time leading up to pregnancy is crucial in creating a healthy foundation for your growing baby. That's where fertility cleansing comes in!

By cleansing the uterus and liver through the use of herbs, you'll be supporting your body in preparation for conception. 

The Fertility Cleanse encourages the liver to cleanse the body of toxins and excess hormones, while also supporting the uterus in cleansing old stagnant blood and increasing circulation.

Ready to get started? 

👇 Type CLEANSE in the comments below and I'll send you my Guide To Fertility Cleansing. 💪 

#FertilityJourney #ReproductiveHealth #Cleansing"

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☕Reproductive Support Tea contains herbs that support, tone, and nourish the female reproductive system while supporting hormone balance.
It’s a soothing and effective fertility tea that provides just the right mixture of beneficial fertility herbs designed to help:

1️⃣ Nourish the uterus*
2️⃣ Support fallopian tube health.*
3️⃣ Help maintain normal ovarian function.*
4️⃣ Encourage normal uterine health.*
5️⃣ Support hormonal balance.

This tea is one of two teas in our Fertility Cleanse Kit. 

👇 To learn more about the Fertility Cleansing type CLEANSE in the comments below and I will send you my Guide To Fertility Cleansing. 👇 

What tea are you drinking today??

naturalfertilityinfo

View

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Get ready to prep your body for conception with Fertility Cleansing 101 🌿

The time leading up to pregnancy is crucial in creating a healthy foundation for your growing baby. That's where fertility cleansing comes in!

By cleansing the uterus and liver through the use of herbs, you'll be supporting your body in preparation for conception. 

The Fertility Cleanse encourages the liver to cleanse the body of toxins and excess hormones, while also supporting the uterus in cleansing old stagnant blood and increasing circulation.

Ready to get started? 

👇 Type CLEANSE in the comments below and I'll send you my Guide To Fertility Cleansing. 💪 

#FertilityJourney #ReproductiveHealth #Cleansing"

naturalfertilityinfo

View

Mar 21

Open
Get ready to prep your body for conception with Fertility Cleansing 101 🌿

The time leading up to pregnancy is crucial in creating a healthy foundation for your growing baby. That's where fertility cleansing comes in!

By cleansing the uterus and liver through the use of herbs, you'll be supporting your body in preparation for conception. 

The Fertility Cleanse encourages the liver to cleanse the body of toxins and excess hormones, while also supporting the uterus in cleansing old stagnant blood and increasing circulation.

Ready to get started? 

👇 Type CLEANSE in the comments below and I'll send you my Guide To Fertility Cleansing. 💪 

#FertilityJourney #ReproductiveHealth #Cleansing

naturalfertilityinfo

View

Mar 20

Open
🥚 In the past, a common belief was that the only factor which determines ovarian and egg health was age. 

Based on new studies, we now know that this may not be true. 🤯

There are many factors that can have an impact on the health of the ovaries and eggs including environmental factors, hormones in the diet, and stress, just to name a few.

In addition, having healthy fertility is based on many additional aspects to consider, including:
➡️ Proper circulation
➡️ A healthy fertility cycle
➡️ Balanced hormones
➡️ Healthy eggs

Egg health is one of the cornerstones of healthy fertility. 

The health of your eggs (ova) can affect whether or not fertilization and implantation will occur as well as the viability of a pregnancy.

During the cycle of an egg’s journey towards ovulation, there is a window of opportunity, a period of time, when certain factors can affect the health of the eggs that are preparing for ovulation. ⏳

This journey takes about 90 days. 

The steps you take today will impact the health of your eggs 3 months from now. 

That is why I talk so much about taking a MINIMUM of 90 days to prepare for pregnancy or IVF/IUI. 

🙂 The good news is that there are steps you can take to help support the health of your eggs. There is too much info to put into this tiny caption but….

Type EGG if you would like me to send you my Egg Health Checklist that takes you through all of the steps to take.👇👇

naturalfertilityinfo

View

Mar 20

Open
5 Steps you can take to help support your fertility naturally…. 👇

1️⃣ Cleanse and prepare the body for conception

2️⃣ Nourish the body with fertility supportive foods

3️⃣ Protect and remove any substances that are causing harm

4️⃣ Learn how to fertility chart and read your monthly cycle

5️⃣ Add lifestyle habits that help to support fertility health

🌼 To learn more on how to support your fertility naturally, type STEPS in the comments below to join my free mini-course - 5 Steps To Improve Your Fertility Naturally, where I go into detail on each of the 5 steps. 👇

#naturalfertility #fertilitytips #gettingpregnant #hormonehealth #hormonalhealth

naturalfertilityinfo

View

Mar 19

Open
Get ready to prep your body for conception with Fertility Cleansing 101 🌿

The time leading up to pregnancy is crucial in creating a healthy foundation for your growing baby. That's where fertility cleansing comes in!

By cleansing the uterus and liver through the use of herbs, you'll be supporting your body in preparation for conception. 

The Fertility Cleanse encourages the liver to cleanse the body of toxins and excess hormones, while also supporting the uterus in cleansing old stagnant blood and increasing circulation.

Ready to get started? 

👇 Type CLEANSE in the comments below and I'll send you my Guide To Fertility Cleansing. 💪 

#FertilityJourney #ReproductiveHealth #Cleansing"

naturalfertilityinfo

View

Mar 19

Open
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A common misconception when it comes to fertility is that if there is an issue it is most likely going to be with the woman. 

This is simply not true. 

Statically fertility issues impact men just as often as women and lifestyle factors can make a big difference. 

The Male Fertility Cleanse Kit helps to support men to cleanse and detox excess hormones, toxins, increase circulation and promote hormone balance. 

👇 Drop MEN in the comments below & I will send you my Male Fertility Checklist with all the details on which herbs, supplements and foods to focus on in addition to cleansing 👇

#malefertilty #naturalfertility #gettingpregnant #fertilitytips

naturalfertilityinfo

View

Mar 18

Open
Is it okay to start a kit and the Fertility Cleanse at the same time?

Do you have natural fertility questions? Type them below. We are happy to help!

naturalfertilityinfo

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Mar 18

Open
📈 Fertility charting will help you to better understand your current hormonal state, when or if you are ovulating and other information about your cycle that will help to bring clarity to your fertility path.

Some things you will be able to see on a fertility chart….📈

🌸Thyroid function
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🌸Length of luteal phase
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👇To begin learning how to fertility chart, type CHART into the comments below and I will share a link to my getting started to fertility charting guide. 👇 

#fertility #fertilitycharting #fertilitytips #fertilitycoach #naturalfertility

naturalfertilityinfo

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Mar 17

Open
The Fertility Cleanse kit is one of the best ways to prepare for conception. 

It's the first step we suggest for most couples when they start trying to get pregnant. 

With over 680 five star reviews, the Fertility Cleanse Kit is by far a customer favorite. 

You can find the Fertility Cleanse Kit on our website. Link in the bio... @naturalfertilityinfo

Want to learn more? 

👇 Type CLEANSE in the comments below and I'll send you my Guide To Fertility Cleansing. 💪
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