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AMH Not Good Predictor of Fertility: Exploring Alternative Assessments

Updated: Nov 29, 2023

For many women, the journey to motherhood can be a challenging one, and one of the key factors that influence a woman's ability to conceive is her ovarian health. In recent years, the Anti-Müllerian Hormone (AMH) test has gained popularity as a marker for assessing ovarian health and, by extension, fertility.

AMH alone is NOT a good predictor of fertility.

What is AMH?

AMH, or Anti-Müllerian Hormone, is a protein produced by the granulosa cells in the small, developing follicles within your ovaries. These follicles contain immature eggs, and their number and

baby feet

quality can significantly affect your fertility. AMH levels can give you insight into the quantity of these developing follicles, often referred to as your ovarian reserve.

The Role of AMH in Infertility

AMH serves as a valuable marker for assessing your ovarian reserve. However, it's essential to understand that it's just one piece of the fertility puzzle. High or low AMH levels alone do not determine your fertility. High levels may indicate polycystic ovarian syndrome (PCOS), which can lead to irregular ovulation, while low levels may suggest a low ovarian reserve.

Assessing Ovarian Health with LH and FSH

FSH standard and optimal reference ranges

In addition to AMH, two other hormones, luteinizing hormone (LH) and follicle-stimulating hormone (FSH), play essential roles in assessing your fertility. LH and FSH are produced by the pituitary gland and help regulate your menstrual cycle and ovulation. High levels of FSH can indicate diminished ovarian reserve, while an imbalance of LH and FSH can be a sign of conditions like PCOS.

Research has shown that AMH and FSH alone are not good predictors of fertility (1). Using these together along with additional testing and a thorough history, can better predict fertility outcomes. One study found that in women <35 years old, FSH seemed to be a better predictor, whereas women >35 years old, AMH was a better predictor (2).

Looking at these Labs:


Standard lab ranges: 0.5 -6.8 ng/mL

Optimal lab ranges: 2 - 4.0 ng/mL

positive pregnancy test

Too high levels may suggest PCOS. Too low levels suggests 'low ovarian reserve'


Standard lab ranges: 2-20 mIU/mL

Optimal lab ranges: <10 mIU/mL

Too high levels may suggest PCOS. Too low levels suggests 'low ovarian reserve'

Better Pregnancy Outcomes =

Low FSH + High AMH

Antral count should also be considered

Lower Pregnancy Outcomes =

High FSH + Low AMH

Other Ways to Assess Ovarian Health

Apart from hormone tests, there are other methods to assess your ovarian health, including:

  1. Ovarian ultrasound: A transvaginal ultrasound can provide a visual of your ovaries, detecting the number and size of follicles.

  2. Antral follicle count: Your doctor may count the small, resting follicles visible on ultrasound, which can provide information about your ovarian reserve.

  3. Hormone monitoring: Tracking your LH and FSH levels throughout your menstrual cycle can help your doctor understand your ovarian function.

  4. Menstrual cycle tracking: Regular, consistent menstrual cycles are often indicative of healthy ovarian function.

Improving Ovarian Health Naturally

While your ovarian health is influenced by various factors, there are steps you can take to naturally support and improve it:

  1. A balanced diet: Nutrient-rich foods, including antioxidants, omega-3 fatty acids, and a variety of vitamins and minerals, can support your reproductive health.

  2. Regular exercise: Maintaining a healthy weight and staying active can help regulate hormones and improve overall fertility.

  3. Stress management: High levels of stress can negatively impact your fertility. Practicing relaxation techniques such as meditation or yoga can be beneficial.

  4. Avoid smoking and excessive alcohol: Both smoking and excessive alcohol consumption can harm your fertility and overall health.

AMH Alone Isn't a Definitive Test for Infertility

It's crucial to remember that AMH, while a valuable tool, doesn't provide the complete picture of your fertility. Assessing fertility is a complex process that requires a comprehensive evaluation, including the assessment of other hormonal markers and physical examinations.


1) PMID: 30012195

2) PMID: 34421292

Work With Me 👇

If you are looking for natural ways to improve your ovarian health including increasing AMH levels, you can click here to sign up with a complimentary 15 minute phone call with me. We can discuss your goals at that time and determine whether or not we will be a good fit for each other.

Dr. Katie Zaremba natural fertility doctor

About Dr. Zaremba

Dr. Zaremba received her bachelor's degree from Western Michigan University in Biomedical Sciences and minored in Chemistry and Psychology. She completed her doctoral training at Palmer College of Chiropractic. During her time in school, she took post-doctoral training through The Clinic on Disease and Internal Disorders (CDID) earning her a Diplomate from the American Board of Chiropractic Internists (DABCI).


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