Low AMH — What It Means and What You Can Do
By Dr (TCM) Attilio D'Alberto | Traditional Chinese Medicine Practitioner, Wokingham
Receiving a low AMH result is one of the most distressing pieces of news a woman trying to conceive can receive. In my fertility clinic I see women who have been told that their AMH is very low and that their chances of conceiving are negligible — and many of them go on to conceive naturally or through IVF with the right support. A low AMH result reflects the size of the remaining egg pool, but it does not tell us about egg quality — and quality is what determines whether a pregnancy occurs and is sustained.
What Is AMH?
Anti-Müllerian hormone (AMH) is produced by the granulosa cells of small antral follicles in the ovaries. It is the most reliable blood marker of ovarian reserve — it reflects how many eggs remain in the pool. AMH levels naturally decline with age but can also be low in younger women due to genetics, previous ovarian surgery, autoimmune conditions, or chemotherapy. Unlike FSH, AMH does not fluctuate significantly across the menstrual cycle and can be tested at any time.
What Low AMH Does Not Mean
Low AMH does not mean you cannot conceive naturally. Natural conception requires only one good egg per cycle, and women with low AMH can and do ovulate every month. It does not reliably predict the chance of natural conception — studies have shown that among women trying to conceive naturally, AMH level does not predict time to pregnancy. It does predict ovarian response to IVF stimulation, which is where its clinical relevance is greatest.
TCM Understanding
In traditional Chinese medicine, AMH is an expression of kidney jing — the fundamental reproductive essence stored in the kidneys that governs fertility, development, and ageing. As kidney jing depletes with age or through constitutional factors, AMH falls in parallel. The goal of TCM treatment is not to restore the total egg count (which is not possible) but to nourish kidney jing, kidney yin, and blood to maximise the quality of the remaining eggs and optimise the conditions in which they develop.
Acupuncture for Low AMH
Research has shown that acupuncture improves ovarian blood flow, which is the rate-limiting factor for follicular development and egg quality. Several studies have demonstrated reductions in FSH levels and improvements in ovarian response following acupuncture in women with diminished ovarian reserve. I treat patients with low AMH weekly for a minimum of twelve weeks before an IVF cycle, with treatment focused on the follicular phase when follicles are actively developing.
Chinese Herbal Medicine
The foundational formulas for kidney jing and kidney yin deficiency are Zuo Gui Wan and Liu Wei Di Huang Wan. Key individual herbs include Shu Di Huang, Gou Qi Zi, Tu Si Zi, and Nu Zhen Zi. I prescribe pharmaceutical-grade granules from Sun Ten in Taiwan, tailored to the individual and adjusted at each follow-up.
Supplements
CoQ10 (ubiquinol, 600mg daily) is the most important supplement for improving mitochondrial function in ageing eggs — it must be started at least three months before a conception attempt or IVF cycle. DHEA (25–75mg daily) has growing evidence for improving ovarian response in diminished reserve — discuss with your IVF clinic. Vitamin D, melatonin, and omega-3 fatty acids complete the foundation. See our full article on how to manage ovarian reserve.
For a personalised low AMH treatment plan, contact me or book a consultation in Wokingham.
