Common symptoms
- •Often none — reserve drops silently
- •Shortening cycles
- •Heavier or lighter flow
- •Difficulty conceiving
What drives it
- •Age (the dominant factor)
- •Genetics
- •Endometriosis or pelvic surgery
- •Chemotherapy or pelvic radiation
- •Autoimmune ovarian conditions
Testing approach
AMH plus an antral follicle count is the standard. We add day-3 FSH, LH and estradiol for a complete reserve picture.
What to do next
- ✓Get baseline reserve data — even if you're not trying yet
- ✓If reserve is low for your age, discuss egg freezing or earlier conception planning
- ✓Optimise modifiable factors: vitamin D, thyroid, weight, smoking, sleep
Frequently asked
It means fewer eggs remaining than average for your age — not infertility. Many women with low AMH conceive naturally; it mostly affects IVF response.
AMH largely reflects fixed biology, but the conditions for ovulation — thyroid, vitamin D, weight, sleep, stress — are very modifiable.
AMH falls steadily: median values are roughly 4.5 ng/mL at 25, 2.5 at 35, 1.0 at 40 and under 0.5 at 45. Age-specific reference matters more than a single number.
Best yield is before 35. If you're 30–37 with a low-for-age AMH, or 37+ and not ready to try, freezing is worth a fertility-specialist conversation.
The pill suppresses AMH by about 20–30% while you're taking it. Levels rebound within 3 months of stopping — so test off the pill for an accurate reading.
Yes — AMH predicts response to IVF stimulation, not natural fertility. Many women with low AMH conceive on the first or second cycle of trying.
References
- ASRM — Ovarian reserve assessment— Clinical use of AMH, FSH and AFC
- ESHRE — Diminished ovarian reserve and poor response— Evidence base for ovarian reserve markers
- RANZCOG — Fertility investigations— Ovarian reserve testing in ANZ fertility practice
References are provided for educational context only. Her Form is not affiliated with these organisations. Always interpret results with a qualified healthcare professional.