Anti-Müllerian hormone (AMH)

On this page

1. What is AMH?
2. Where is AMH produced?
3. Function of AMH
4. Normal AMH levels
5. AMH levels by age
6. Causes of low AMH
7. Causes of high AMH
8. When and how to test AMH
9. AMH in traditional Chinese medicine
10. Acupuncture and AMH
11. Chinese herbal medicine and AMH
12. Diet, supplements and lifestyle
13. Related pages

1. What is AMH?

Anti-Müllerian hormone (AMH) is a glycoprotein hormone produced by the granulosa cells of small developing follicles in the ovary. It has become the most accurate single marker of ovarian reserve — the quantitative measure of how many eggs a woman has remaining. AMH has largely replaced FSH as the primary marker of ovarian reserve because it is more stable across the menstrual cycle, can be tested at any time, and more directly reflects the size of the follicle pool.

AMH is a measure of egg quantity, not egg quality. A woman with a low AMH may still have good-quality eggs and conceive naturally; conversely, a woman with a high AMH (such as in PCOS) may have poor egg quality despite plentiful follicles.

Reference ranges vary from country to country and between laboratories. Different units are used (ng/mL, pmol/L) and different assay methods give slightly different results. Always interpret your own AMH result against the laboratory's own reference range, and ideally test in the same laboratory each time to allow direct comparison.

2. Where is AMH produced?

AMH is produced by the granulosa cells of pre-antral and small antral follicles in the ovary. Each follicle that is recruited towards ovulation contributes a small amount of AMH; the total measured in the blood is therefore proportional to the size of the developing follicle pool. AMH is also produced by Sertoli cells in the male testis, where it has a different role in fetal development of the male reproductive tract.

3. Function of AMH

In adult women, AMH appears to act as a "brake" on follicle recruitment, limiting the number of follicles that respond to FSH each cycle. This is one of the mechanisms by which the ovaries conserve their finite supply of eggs over the reproductive years.

For clinical purposes, AMH is mainly used as a marker of ovarian reserve and a predictor of response to ovarian stimulation in IVF.

4. Normal AMH levels

The following are general guides drawn from UK and international literature:

Reference ranges vary from country to country and between laboratories. The values above are general guides — always interpret your own result against the laboratory's reference range. To convert ng/mL to pmol/L, multiply by 7.14.

5. AMH levels by age

AMH declines progressively with age. The following table shows typical AMH levels by age:

These are population averages — individual women vary considerably. A woman with an AMH below the average for her age can still conceive naturally; it only takes one good-quality egg.

6. Causes of low AMH

Low AMH is caused by:

1. Ageing — the most common cause; AMH falls progressively from around age 30.
2. Premature ovarian failure or insufficiency.
3. Genetic factors — including Fragile X premutation and Turner syndrome.
4. Previous ovarian surgery — particularly removal of an ovary or treatment of endometriomas.
5. Chemotherapy and radiation.
6. Smoking — research has shown reduced AMH in women exposed to cigarette smoke or wood smoke.
7. Severe nutritional deficiency and chronic illness.

7. Causes of high AMH

High AMH is most commonly seen in PCOS, where the ovaries contain a large number of small follicles each producing AMH. Recent research has shown that acupuncture can reduce and normalise high AMH levels in women with PCOS.

8. When and how to test AMH

AMH can be tested at any point in the menstrual cycle, although recent research suggests levels are slightly higher in the first half of the cycle before ovulation. AMH is unaffected by oral contraceptives in the long term, but levels can be transiently lower in women on combined hormonal contraceptives, so retesting after stopping is sometimes advisable. AMH is more stable than FSH from cycle to cycle, but levels can fluctuate, so retesting after three months is reasonable if a result is unexpected.

Reference ranges vary from country to country. Always interpret your own result against the laboratory's reference range and discuss it with your doctor.

9. AMH in traditional Chinese medicine

In traditional Chinese medicine, AMH most closely corresponds to Kidney Jing (essence) — the foundational, deep, finite reserve that governs reproductive maturation, fertility and longevity. Low AMH reflects Kidney Jing deficiency, often combined with Kidney Yin and Blood deficiency. Symptoms typically include lower back ache, dark circles under the eyes, premature greying of the hair, dry skin and a sense of physical depletion.

10. Acupuncture and AMH

Acupuncture has been shown in research to improve ovarian reserve, increase antral follicle count and reduce high AMH in women with PCOS. By improving ovarian blood flow, regulating the HPO axis and reducing oxidative stress, acupuncture provides whole-system support to the ovary. Treatment is typically weekly for at least three to four months — the time needed for follicles to mature from primordial to ovulation.

See my dedicated page on low AMH level for full clinical detail and patient experience.

11. Chinese herbal medicine and AMH

Chinese herbal formulae that nourish Kidney Jing, Yin and Blood are used to support women with low AMH. Examples include Zuo Gui Wan, Yu Lin Zhu, Gui Lu Er Xian Jiao and Wu Zi Yan Zong Wan. Where Liver Qi stagnation from chronic stress is also present, Xiao Yao San is added. For high AMH in PCOS, formulae such as Cang Fu Dao Tan Tang are used.

12. Diet, supplements and lifestyle

To support healthy AMH and ovarian reserve:

1. Take a good-quality prenatal supplement.
2. Consider DHEA (25–75 mg/day) under professional guidance — research has shown it can improve egg quality and ovarian response.
3. Coenzyme Q10 (600 mg/day) — supports mitochondrial function in the egg.
4. Royal jelly and bee pollen — traditionally used to nourish Jing.
5. Melatonin (3 mg at night) — a powerful antioxidant that protects egg quality.
6. Eat plenty of iron- and protein-rich foods.
7. Avoid smoking and exposure to second-hand smoke.
8. Sleep before 10 p.m.
9. Reduce psychological stress.

13. Related pages

• Fertility hormones directory
• Follicle stimulating hormone (FSH)
• Dehydroepiandrosterone (DHEA)
• Oestrogens
• Low AMH level (clinical page)
• Premature ovarian failure
• PCOS
• My Fertility Guide