AMH
Anti-Müllerian hormone (AMH) is produced by the granulosa cells of small antral follicles and is the most direct serum readout of remaining ovarian reserve. Levels decline steadily from the mid-20s and become undetectable several years before the final menstrual period. For women considering the timing of pregnancy, egg freezing, or simply wanting to map their reproductive runway, AMH is the single most informative number on a fertility panel.
Why this biomarker matters
AMH integrates two clinically meaningful signals: how many follicles you have left, and roughly how soon menopause will arrive. Large cohort data (the SWAN study and others) show that AMH predicts age at menopause within about two to three years when measured in the mid-30s and later. Below-age-expected AMH flags diminished ovarian reserve, which lowers the response to IVF stimulation and shortens the window for spontaneous conception. Very low AMH does not mean infertility today; many women conceive naturally with AMH under 1.0 ng/mL. But it does mean the trajectory is compressed. On the other end, elevated AMH (often above 5 ng/mL in women under 35) is part of the polycystic ovary syndrome (PCOS) phenotype and associates with anovulatory cycles, hyperandrogenism, and metabolic dysfunction. Treating AMH as a trend across years, alongside antral follicle count on ultrasound, gives a far more reliable picture than any single value.
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These biomarkers contextualize and unlock a clearer picture than any single value can.
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