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Evidence Library · Tests that do not predict

AMH does not tell you whether you can get pregnant

It predicts how many eggs a stimulation cycle will yield. That is a different question.

This is the most consequential misunderstanding in fertility testing, and it has been directly tested.

750 women aged 30 to 44 with no history of infertility, who had been trying for three months or less, were followed to pregnancy or twelve cycles. Their AMH, FSH and inhibin B were measured at the start. Adjusted for age, body mass index, race, smoking and recent contraceptive use:

GroupNumberConceived by 12 cycles
Low AMH, under 0.7 ng/mL8484% (95% CI 70 to 91)
Normal AMH57975% (95% CI 70 to 79)
High serum FSH, over 10 mIU/mL8382% (95% CI 70 to 89)
Normal serum FSH65475% (95% CI 70 to 78)
Read that table carefullyThe 84% belongs to the women with the low AMH. None of these differences was statistically significant, and the confidence intervals overlap heavily. The correct reading is not that low AMH is better. It is that the test carried no signal at all about whether these women would conceive.

The authors' own conclusion: biomarkers indicating diminished ovarian reserve compared with normal ovarian reserve were not associated with reduced fertility. These findings do not support the use of urinary or blood follicle-stimulating hormone tests or antimüllerian hormone levels to assess natural fertility for women with these characteristics.

ACOG's position, quoted exactly: Serum antimüllerian hormone level assessment generally should not be ordered or used to counsel women who are not infertile about their reproductive status and future fertility potential. ACOG adds that AMH is unsuitable for predicting menopause, is not part of the diagnostic criteria for polycystic ovary syndrome, and is not recommended for predicting pregnancy loss.

Where AMH genuinely is usefulAMH does predict how many eggs your ovaries will produce in response to stimulation drugs. If you are already going through IVF, that is a real and useful thing to know, and it is why the test exists. The failure is not the test. It is the use of a test built for one question to answer a different one.
Where this comes from:
21. Steiner AZ, Pritchard D, Stanczyk FZ, Kesner JS, Meadows JW, Herring AH, et al. Association between biomarkers of ovarian reserve and infertility among older women of reproductive age. JAMA. 2017;318(14):1367-1376.
22. The use of antimüllerian hormone in women not seeking fertility care. ACOG Committee Opinion No. 773. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2019;133(4):e274-e278. Reaffirmed 2024.
127. Practice Committee of the American Society for Reproductive Medicine. Testing and interpreting measures of ovarian reserve: a committee opinion. Fertil Steril. 2020;114(6):1151-1157.
10. Practice Committee of the American Society for Reproductive Medicine. Fertility evaluation of infertile women: a committee opinion. Fertil Steril. 2021;116(5):1255-1265.

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