Should you get an anti-mullerian hormone test?

“Had I known earlier, I think I would have made different decisions that would have benefited me very differently now.” 

Kelly, who prefers not to use her real name because of wanting privacy around her fertility journey, is talking about finding out at 35 that her anti-mullerian hormone (AMH) level was severely low for someone her age. 

Despite all the medical advances happening every day, fertility remains a bit of a mystery. There is no way to predict how likely a woman is to get pregnant—and nearly 1 in 6 women will face fertility issues.

That can be a frustrating feeling, especially since many women, like Kelly, don’t find out about any issues impacting their fertility until after they’ve already had difficulty trying to conceive. 

Kelly and her partner had been trying to get pregnant for six months when she asked her OB-GYN if there was any testing to see what might be contributing to their lack of success. That’s when she found out her AMH level was low. 

She wishes she had been more proactive about her fertility and that her doctor had told her about the simple blood test sooner.

What is AMH and what does it mean for your fertility?

Essentially, an AMH blood test can give a woman an idea whether the number of eggs she has left is considered normal for her age or not, since AMH levels naturally decline with age. 

“Every follicle, which turns into an egg that can be released during menstruation, contains AMH that is released into the bloodstream. How much AMH is detected in your blood can give doctors an idea of the number of eggs you have in your body,” explains Dr. Jennifer Hintzsche, PhD, CEO and founder of PherDal Fertility Science. The number of eggs that someone has left is also commonly referred to as their ovarian reserve. 

“You have a large amount of ovarian reserve until about age 32,” says Damian Alagia, MD, Senior Medical Director for Advanced Diagnostics and Women’s Health at Quest Diagnostics on behalf of questhealth.com. “And then you begin to see more of a precipitous fall-off from 32 to 35. And then you see this big fall off.” 

Dr. Hintzsche cautions that an AMH test does not give an indication of egg quality—and that studies have shown that AMH levels are not a predictor of whether someone will have fertility challenges down the line.

“You can have a low AMH and have no problem at all getting pregnant, and you can have a high AMH and have difficulty getting pregnant,” adds Dr. Alagia.

Research suggests AMH levels can predict IVF outcomes

However, there are studies that suggest AMH levels can predict IVF outcomes—and that women with lower AMH levels may see reduced success with the number of eggs they’re able to retrieve during an IVF cycle, which can contribute to a lower overall success rate with IVF. 

IVF outcomes also decline as women get older, as egg quality tends to decline with age.

That’s what makes Kelly upset. She was 34 years old the first time she had her AMH level tested—and wishes she would have known about the blood test in her 20s. 

She starts to choke up as she thinks about what she would have done if she had found out her AMH level was low earlier on. “I would have taken the test at 25, and then again at 28 and 30 when I very well knew I wanted kids. What would I give to be 28 to be able to do one round of IVF and at least get a couple of eggs.”

Instead, she says, as she wipes away tears, she’s done three rounds of IVF and has only been able to retrieve four mature eggs total. She’s now 35 and feels like between getting older and having a low ovarian reserve that the deck is stacked against her for getting pregnant. 

Is there value in getting your AMH level tested when you are young?

“Benchmark data with simple tests, like AMH, is a smart and empowering option,” says Dr. Hintzsche. “When you can gather data and be proactive in your fertility journey in advance, it can help you make the best, most informed decisions for yourself and your future children.” She wants people to keep in mind, though, that your AMH level is just one data point and that decisions shouldn’t be based solely on one test. 

Dr. Alagia is less convinced about the benefits to getting an AMH test done proactively, since there are so many variables that contribute to fertility. That said, he does agree that being proactive about your health is always a good idea.  

“An AMH test could be the first step. Anything that initiates discussions between you and your spouse or your significant other and your health care professional I think is incredibly valuable.”

Kelly is adamant that “knowledge is power” and that there doesn’t seem to be a downside to getting an AMH test done before someone is trying to conceive as long as they don’t make any decisions from the test results alone. There are many at-home AMH tests available on the market (Dr. Alagia likes the one from Quest Health), but the authors of a 2023 JAMA study state that some people who test on their own at home “may be falsely reassured by test findings and as a result delay plans to conceive,” or, vice versa: “may be needlessly concerned if they receive a low test result, fearing this suggests subfertility or possible future problems conceiving.”

If you’re curious about your personal AMH level, it’s best to talk to your OB-GYN, who can help you decipher the results and determine your best next steps.