A low Anti-Müllerian Hormone (AMH) level can be concerning, especially when you are trying to conceive. However, low AMH does not mean that pregnancy is impossible.
AMH is primarily used as a marker of ovarian reserve—the estimated number of eggs remaining in the ovaries. It can help provide information about how the ovaries may respond to fertility treatment, but it does not directly measure egg quality or determine whether natural conception can occur.
At Longevity Fertility Centre, we provide individualized fertility care for women with low AMH and diminished ovarian reserve in Calgary and Edmonton.
What Is AMH?
Anti-Müllerian Hormone is produced by small follicles within the ovaries. A blood test can measure AMH and provide an estimate of ovarian reserve.
In general, AMH levels gradually decline with age as the number of remaining ovarian follicles decreases.
AMH testing is commonly used during fertility evaluation and before treatments such as IVF.
What Does Low AMH Mean?
Low AMH usually indicates that the ovaries contain fewer remaining follicles than expected for a person’s age.
This is often described as diminished ovarian reserve (DOR).
Low AMH may be associated with:
- A lower number of eggs available for recruitment
- A reduced response to ovarian stimulation during IVF
- Fewer eggs retrieved during an IVF cycle
- A potentially shorter reproductive window
However, AMH is only one part of a fertility assessment.
Some women with low AMH continue to ovulate regularly and may still conceive naturally.
Low AMH Does Not Measure Egg Quality
One of the most important distinctions is that AMH primarily provides information about egg quantity, not egg quality.
Egg quality is influenced much more strongly by age.
For example, a younger woman with low AMH may have fewer available eggs but may still have a relatively favorable proportion of genetically normal eggs compared with an older woman.
For this reason, AMH should always be interpreted together with age, menstrual history, ultrasound findings, and other fertility testing.
What Causes Low AMH?
Low AMH can occur for several reasons, including:
- Increasing age
- Genetic factors
- Previous ovarian surgery
- Endometriosis
- Chemotherapy or radiation treatment
- Certain autoimmune or medical conditions
- Premature ovarian insufficiency
- A naturally lower ovarian reserve
In some women, there is no identifiable cause.
Symptoms of Low AMH
Low AMH itself usually does not cause obvious symptoms.
Many women discover that their AMH is low only after undergoing fertility testing.
Menstrual cycles may still be completely regular.
In more advanced cases of declining ovarian function, some women may experience:
- Shorter menstrual cycles
- Irregular periods
- Missed periods
- Changes in menstrual flow
These symptoms may warrant further evaluation.
How Is Low AMH Evaluated?
A fertility evaluation should look beyond AMH alone.
Depending on your situation, testing may include:
AMH
Provides an estimate of ovarian reserve.
Antral Follicle Count (AFC)
A transvaginal ultrasound can count the number of small follicles visible in the ovaries early in the menstrual cycle.
FSH and Estradiol
Follicle-stimulating hormone (FSH) and estradiol are often measured early in the menstrual cycle and can provide additional information about ovarian function.
Ovulation Assessment
Progesterone testing or cycle monitoring may help determine whether ovulation is occurring normally.
Thyroid and Prolactin Testing
Hormonal abnormalities can sometimes affect menstrual cycles and fertility.
Fallopian Tube Assessment
Tests such as hysterosalpingography (HSG) may be recommended to determine whether the fallopian tubes are open.
Semen Analysis
Male fertility should also be evaluated, as fertility depends on both partners.
Can You Get Pregnant Naturally With Low AMH?
Yes.
Low AMH does not automatically mean that natural conception is impossible.
If ovulation is occurring, the fallopian tubes are open, and sperm parameters are adequate, pregnancy may still occur.
AMH is not considered a reliable test for predicting whether an individual woman will become pregnant naturally within a specific month.
However, lower ovarian reserve may mean that there is less time available to achieve pregnancy, particularly when age is also a factor.
For this reason, women with significantly reduced ovarian reserve may benefit from discussing their fertility plans sooner rather than later.
Low AMH and IVF
AMH is particularly useful in predicting how the ovaries may respond to fertility medications during IVF.
Women with low AMH may produce fewer follicles and therefore retrieve fewer eggs during an IVF cycle.
This does not necessarily mean that IVF cannot be successful.
Treatment planning may depend on:
- Age
- AMH level
- Antral follicle count
- Previous response to fertility medications
- Egg and embryo quality
- Semen parameters
- Overall reproductive history
Some patients may require more than one stimulation or egg-retrieval cycle to obtain an adequate number of embryos.
Can AMH Be Increased?
AMH levels can fluctuate somewhat between tests, but there is currently no established treatment that reliably restores ovarian reserve or replaces eggs that have already been lost.
Because of this, fertility care should focus less on trying to increase the AMH number itself and more on understanding your overall reproductive health and making appropriate decisions based on your individual circumstances.
When Should You Seek Fertility Care?
You may want to consider a fertility evaluation if:
- You have been told that your AMH is low
- Your antral follicle count is reduced
- You have a family history of early menopause
- You have had ovarian surgery
- You have endometriosis
- You have experienced repeated unsuccessful fertility treatments
- Your menstrual cycles have become shorter or irregular
- You are concerned about your reproductive timeline
Women over age 35 or those with known diminished ovarian reserve may benefit from seeking fertility guidance without waiting a full year of trying to conceive.
A Low AMH Result Is Only One Piece of the Picture
Receiving a low AMH result can feel discouraging, but the number should not be interpreted in isolation.
A complete fertility assessment considers your age, menstrual cycle, ovulation, ultrasound findings, reproductive history, fallopian tubes, sperm parameters, and other laboratory results.
Understanding the complete picture can help you make more informed decisions about natural conception, fertility preservation, IUI, IVF, or other reproductive options.
Fertility Care for Low AMH in Calgary and Edmonton
Longevity Fertility Centre provides personalized fertility and reproductive health care for patients with low AMH and diminished ovarian reserve.
Your consultation includes a detailed review of your fertility history, menstrual cycle, laboratory results, imaging, previous treatments, and reproductive goals.
In-person and online appointments are available in Calgary and Edmonton.