AMH: What the Numbers Really Mean for Your Fertility

Why AMH Is More Than Just a Number

If you’ve been told your AMH is “too low” for your age or that it means your chances of conceiving are slim, you’re not alone. Many women are told their only option is IVF or donor eggs. But AMH is not just a fertility number, it’s a biomarker that offers clues about what’s happening inside your body.

• Conventional medicine uses AMH to measure ovarian reserve.

• Functional fertility sees AMH as a signal of underlying imbalances like inflammation, nutrient deficiencies, thyroid dysfunction, or autoimmune activity.

📖 Related reading: Can Low AMH Improve Naturally?

AMH Levels Across Ages

According to the Cleveland Clinic, here are typical benchmarks:

• 25 years old: ~3.0 ng/mL

• 30 years old: ~2.5 ng/mL

• 35 years old: ~1.5 ng/mL

• 40 years old: ~1.0 ng/mL

• 45 years old: ~0.5 ng/mL

👉 “Normal” falls between 1.0–3.0 ng/mL.
👉 “Low” is below 1.0 ng/mL.
👉 “Severely low” is below 0.4 ng/mL.

Large-scale studies confirm AMH naturally declines with age. However, AMH is a poor predictor of natural conception or live birth outcomes. In fact, a major study published in JAMA followed women aged 30–44 with no history of infertility and found that low AMH was not associated with reduced fertility or lower chances of getting pregnant (Steiner et al., 2017)

This is important because many women are told their AMH number alone defines their fertility potential, but the evidence shows otherwise. AMH gives us valuable clues, but it’s just one part of the bigger fertility picture.

Functional Fertility Lens on AMH

Inflammation and Egg Quality

• hsCRP and homocysteine are overlooked in conventional care but strongly linked to egg quality and pregnancy loss (NIH study).

Thyroid Dysfunction

• Even “normal” TSH may not be optimal. Antibodies (TPO, TBG) play a big role in miscarriage and diminished ovarian reserve.
  Send a message to hello@fabfertile.ca - subject line THYROID for our free thyroid guide

Nutrient Deficiencies

• Low vitamin D is correlated with poor IVF outcomes and lower AMH (NIH study).

• Low ferritin impairs egg development and early pregnancy.

Autoimmunity & Gut Health

• ANA, celiac screening, and gut inflammation often explain “unexplained infertility.”
  📖 Related: Fertility and Gut Health Connection

Tests Beyond AMH

Key labs that give a fuller picture include:

• FSH & Estradiol (Day 3 labs)

• Antral Follicle Count (AFC)

• Thyroid panel with antibodies

• Prolactin

• hsCRP & Homocysteine

• Vitamin D

• Ferritin

• Celiac screen (tTG-IgA)

• ANA/autoimmune markers

Success Story – Heather

Heather came to Fab Fertile with an AMH far below her age range. She’d been told her only option was donor eggs after three failed IVF cycles.

Through functional testing we uncovered:

• Low ferritin and vitamin D

• Thyroid antibodies

• Elevated inflammation markers

With a targeted plan, nutrition, supplements, gut healing, and lifestyle shifts, Heather’s cycles improved. She conceived after her next IVF cycle and delivered a healthy baby girl.

📖 Read more about Heather's story.

Every fertility journey is unique. This story is shared for educational purposes only and does not guarantee similar results. Always consult with your healthcare provider about your individual situation. If you’d like to explore how a functional approach could fit your case, book a call here.

Next Steps in Your Fertility Journey

Subscribe to Get Pregnant Naturally for evidence-based guidance on functional fertility, and share this episode with anyone on their fertility journey.

Not sure where to start? Download our most popular guide:  Ultimate Guide to Getting Pregnant This Year If You Have Low AMH/High FSH it breaks everything down step by step to help you understand your options and take action

For personalized support to improve pregnancy success, book a call here.

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TIMESTAMPS

1. [00:00] AMH: What the Numbers Really Mean 

2. [00:01:00] Who This Helps: Low AMH, High FSH, DOR, POI, Failed IVF

3. [00:01:50] AMH Levels by Age: Cleveland Clinic Benchmarks Explained

4. [00:02:40] Does AMH Predict Pregnancy? Egg Quantity vs. Egg Quality

5. [00:03:20] Functional Fertility Lens: What Low AMH Is Signaling

6. [00:04:20] Tests Beyond AMH: Day-3 FSH, Estradiol, and AFC Ultrasound

7. [00:05:40] Thyroid & Fertility: Optimal TSH, Free T4/T3, Antibodies (+ Free Guide)

8. [00:07:20] Hidden Inflammation: hsCRP, Homocysteine, MTHFR & Egg Quality

9. [00:08:50] Vitamin D, Iron & Ferritin: Nutrient Deficits That Lower AMH

10. [00:10:40] Gluten/Celiac & Autoimmunity (ANA) + When to Pause IVF & Heather’s Success

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TRANSCRIPT

[00:00:00] If you've been told that your AMH is too low for your age or that it means your chances of pregnancy are slim, this episode is for you. AMH is not just a fertility number, it's a signal about what may be happening in your body and it deserves a closer look.

Today, you'll learn what AMH values look like across different ages. Why low AMH should not be ignored. What other basic tests you need to look at beyond the AMH and how women like Heather, our client were able to move forward successfully even when she had super low AMH and told donor eggs are her only option, let's go.

Welcome back. I'm Sarah Clark, founder of Fab Fertile. For over a decade, my team and I have helped hundreds of couples improve their chances of pregnancy success, whether naturally or through IVF. We specialize in supporting those with low AMH, high FSH, diminished ovarian reserve, premature ovarian sufficiency, and recurrent pregnancy loss through functional testing and personalized fertility strategies.

[00:01:00] This episode today is for you is if you've been diagnosed with low AMH high FSH diminished ovarian reserve, or premature ovarian insufficiency. You've experienced recurrent pregnancy loss or failed IVF cycles, and you want to understand exactly what the role of AMH plays and you want to look at your AMH number through a functional fertility lens, not just the conventional numbers only approach.

Thanks so much for listening. I'm so thankful that you're here. Make sure you hit subscribe or follow, and if you know someone else who's on the fertility journey, please share this podcast with them.

The conventional medicine view on AMH looks at AMH to measure your ovarian reserve. Essentially how many eggs you have left and how well you might respond to IVF stimulation. So the Cleveland Clinic is going to outline some of these benchmarks.

If you're 25, they like it around 3 ng/mL, 30 at 2.5 ng/mL 35. We wanted at 1.5 ng/mL. 40 at 1 ng/mL and 45 0.5 ng/mL, the average would then fall between 1-3 ng/mL, and low [00:02:00] was considered anything below 1 ng/mL severely low below 0.4 ng/mL. Large scale studies confirm that age related decline median AMH values are around 2.9 ng/mL in women under 30 2 ng/mL in the mid 30's, and less than 1 ng/mL by early 40's.

So conventional low AMH is often framed as bad news, and many women are told that IVF with their own eggs is unlikely, and that donor eggs are their only option. So a lot of the times this AMH number, it can worm its way into our subconscious. We think that the only option is for us to do IVF quickly or we're told donor eggs and then no one looks beyond the AMH number.

AMH is a poor predictor of live birth outcomes. It does not measure your egg quality. It doesn't look at your uterine receptivity, and it does not predict your ability to get pregnant naturally. We still need to know the number. That's a clue for us to [00:03:00] dig deeper with our health. So from a functional fertility lens we can really look at the AMH is not about egg counts.

It's a biomarker, a clue as to what's happening. So if your AMH is low for your age, it may be pointing to accelerated follicle loss or risks of early menopause, which is everyone panics, right? AMH oh. Now we're going into menopause. Our whole thesis on this, is it early menopause or is it your adrenals that impact the thyroid, which impacts the AMH and the FSH, the follicle count again.

Digging deeper. When the AMH is also low. It could be indication of hormonal or metabolic imbalances that impact your ovarian function or inflammation, which I've done many podcast episodes on that. Talking about measuring the hsCRP. We want to look at these other biomarkers in conjunction with the AMH. Nutrient deficiencies, which we see across the board in chronic stress.

We see if your AMH is low, that autoimmune or endocrine issues, they can influence your ovarian health. [00:04:00] So AMH is never the final word. It's part of the picture. We need to know what it is. We're not going to be blind to it and not go and measure things. And we want to look at structurally too, to make sure from a structural standpoint, you're able to, carry a child, but then we need to dig deeper beyond just the conventional medicine saying.

Here's your AMH and you've got nothing to do. So tests looked at beyond the AMH include. FSH and estradiol so those are done on day three. FSH reflects how hard the brain is working to recruit eggs and estradiol can mask a high FSH.

So both matter together. So usually in conventional medicine you're going to get those numbers. Many women are told only the AMH number and sometimes they don't get these, but typically most people I see have got the FSH have got the estradiol done on day three. The antral follicle count, most people are getting this done.

So an ultrasound that shows small resting follicles. It confirms whether AMH reflects what's actually happening in the ovaries. And it's typically [00:05:00] done in IVF settings. It's rarely done with your OB, GYN. It's often done in a fertility clinic. So most people I'm talking to, they already know what their antral follicle count is.

And then thyroid function. So most people are getting the TSH done. Thyroid imbalance can lower ovarian function, raise miscarriage risk. So even a normal TSH. You're told, your thyroid is normal. Air quotes. But we need to dig deeper beyond the TSH number and conventional medicine, they're just looking at the TSH saying, Hey, everything looks good.

There's nothing to worry about here. Don't worry about this. It's totally fine. But it's not about not worrying. It's about digging deeper and missing a clue that they just looked at the TSH and they didn't look at the full panel. A lot of the times they're not looking at the full panel, they're not looking at the antibodies.

This can be an indication of why maybe you're having pregnancy loss or why you have diminished ovarian reserve to begin with if the thyroid is not optimal. We don't want normal, we want [00:06:00] optimal. I've done numerous podcast episodes on the thyroid and also there's a thyroid guide. Send me a message at hello@fabfertile.ca.

Subject line THYROID and the thyroid guide on the symptoms you can have with thyroid issues. This is something that we see all the time with low AMH high FSH, DOR, POI, recurrent pregnancy loss, thyroid issues where it's not normal, where you're being told it's normal, but it's not optimal.

No one's looking at the FREET4 or the FREET3, or no one's looking at antibodies or people being recommended IVF and their antibodies are a hundred, 400, 900 and we like the antibodies for the TPO below 10, the TPG below 30. If it's trending the wrong way, that could be why things aren't working. Prolactin.

Many people are getting prolactin done. I see that regularly when people are showing blood work to start with. So all these numbers, if you decide to work with us, we have an extensive list of blood work. It's a two page list of blood work that we're asking for you can get from your [00:07:00] PCP or if you run into snags there, we have access to the blood work.

We can get that in the States are in Canada. Sometimes when you you ask for some of these numbers, they're like why do you need that for? That's not necessary. Or maybe their hands are tied too. because it's not covered by insurance. So they're not being able to recommend it for you.

Basically we need to find a different provider. If they're not going to give you the blood work that you need to determine what's going on with your health, they're not the provider for you. So we can get access to this. We'd like you to take a first kick with it, with your provider so you can get it covered by insurance.

But, we've got to dig deeper on this. Elevated prolactin can disrupt ovulation, lower progesterone. Sometimes it's ordered in conventional medicine with your provider. But mild elevations are often.

And that can contribute to poor ovarian response inflammation, oxidative stress, so the high sensitivity C-reactive protein, the homocysteine. So high sensitivity, c-reactive protein. I've got a whole podcast episode. Definitely check it out. Signal systemic inflammation.[00:08:00]

So a lot of times it could be the chronic stress and then tips all the biomarkers the wrong way. And you've got all this internal inflammation going on. Elevated homocysteine is linked to poor egg quality and pregnancy loss. And not assimilating some of your B vitamins.

So we see that MTHFR gene variant. There's a whole podcast episode I have on homocysteine. In conventional medicine this is rarely checked. In functional fertility lens we always look at this to identify those hidden inflammatory or vascular risk.

We need to make sure things are optimal there. Vitamin D deficiency is going to lower IVF success, impact egg and embryo development. I cannot tell you the number of people. I can't tell you the number of people that I speak with, that they've either been told their vitamin D is normal, and I ask what it is.

They tell me it's 30. Anything over 30 is normal in conventional medicine, we like it between 60 to 80. I've got people saying, oh yeah my vitamin D was low, but I started supplementing with it. So supplementation can be good. We need to see why is it low, and typically because there's gut issues going on in there, you're not absorbing it.

Also, there could be [00:09:00] genetic issues as well, so it is multi, multifactorial and supplementing can be part of the equation, but just doing that by itself is not going to give you the best results.

Vitamin D can can lower IVF success, impact egg and embryo development. Conventional medicine it's not part of the standard fertility labs. It's a simple test that is often missed and it is a clue for us to dig deeper. If you've got your vitamin D in the single digits or teens or below 30, we have got to work on your health.

We don't just race ahead to IVF. We don't just take the vitamin D3/K2, although we do, but we need to dig into why it's low to begin with. Iron and ferritin have done many episodes on this too. Ferritin will show the iron storage, so low levels will impair egg development, and early pregnancy support.

And so in conventional medicine, the hemoglobin may be checked, but typically the ferritin is overlooked. It's more sensitive and gives the real picture we like before. IVF, the ferritin would be around 80 to 100. We regularly see, another theme with the low [00:10:00] AMH piece is that we see the iron being low and then the iron impacts the thyroid.

This is all connected. It's not just oh wow, I've been anemic for years. I've been taking iron transfusions. And then wonder why the AMH is low when you've been told that donor eggs are your only option. We've got to take our health in our own hands and get a team that doesn't gaslight you and think that you're bananas.

'cause you're saying there's something wrong here. They're like, don't worry, everything's normal. It's not normal. You want to make sure things are optimal. So we need to be our own advocate. Celiac screening. We do need to be careful of the Celiac screening, saying, oh wait, I got tested for celiac and everything was great.

I did the test here and it came back. I don't have celiac. Woo hoo. I'm going to eat all this gluten. So I'm going to tell you a theme that we see with low AMH is non celiac gluten sensitivity. Undiagnosed celiac disease is linked to diminished ovarian reserve. Miscarriage and poor fertility treatment outcomes.

So actual full-blown celiac. But what we see with people that have DOP, [00:11:00] POI, low AMH, high FSH, recurrent pregnancy losses, they are very sensitive to gluten. So even having a crumb, I got people, they're saying that they're gluten-free and then they go to church and have the wafer for communion and next thing you know that's causing inflammation in your body.

So we have people taking out gluten and dairy for 60 to 90 days. And then also doing food sensitivity testing to be able to reduce inflammation in a targeted manner and do this do this very systematically. We need to reduce inflammation. So send me a message at hello@fabfertile.ca, subject line 10 DAY, I'll send you that elimination diet.

But this piece is key. The gluten side of things is overlooked. It's not part of routine labs. It's a critical test, especially if you've got unexplained fertility. Don't even listen to that. They're telling you it's unexplained. We've got someone that's, that had unexplained fertility and she's pregnant with twins right now.

So it was not unexplained. She had a whole host of different health issues that we worked on, and she made the changes. Then also people that are dealing with pregnancy loss, like this stuff is heartbreaking. We've just really got to, get [00:12:00] the right team. It's not about excluding your REI or your OB/ GYN, we have an OB/GYN, with a functional medicine background

as part of our team. We need to look at the nutrition side of things and then the mindset. Regulating your nervous system. If you're in the fight or flight, 'cause your nervous system is so dysregulated from all the stress that you're going through here. I'm just blowing a whole bunch of stuff out here.

This is emotional stuff. It can impact every aspect of your life. We've got to really be kind and gentle with ourselves and each day we make small steps and advocate for ourselves and know there's things we can do and not just oh wait, it's the AMH. I better save up all my money for IVF. I see people doing that and they've thrown all their money in the garbage, because it hasn't worked.

They've had poor retrievals, the transfer didn't work and then their health is even worse. They come off an IVF cycle. Their hormones are all over the place, and then they think they're going in into menopause because they've got all these perimenopausal symptoms. We need to step back and be able to reset the body.

Your body is [00:13:00] not broken. It wants to procreate. Something is happening right now and it's trying to protect you, trying to keep you alive and not able to sustain life. So we need to be able to look at this in a systematic way. Autoimmune markers. I've done many episode.

I did an episode on the ANA, so the anti-nuclear antibodies and really why these are key and typically autoimmune activation can damage ovarian reserve.

It can impact your implantation. It's dismissed as unnecessary in most clinics. And it's essential when you have recurrent pregnancy loss or failed IVF or that air quote, unexplained piece. So if you've got a full blown autoimmune disease, you've got Hashimoto's or Celiac or MS, or you've got rheumatoid arthritis, ulcerative colitis, I've got people coming in saying they have Crohn's or colitis, and then they're just wondering why.

They're being told it's unexplained or they're wondering why their AMH is low. With Crohn's or colitis you're not even absorbing all the nutrients. I got people that have bariatric surgery and wondering why, they've had their stomach [00:14:00] reconstructed and there's huge nutrient deficiencies going on in here and wondering why their hormones are at risk.

So the health of the gut is key. I've done many episodes on that. So the bottom line here is, to me, it's good news. It's not just oh wait a minute, there's nothing I can do. I just need to save my money for IVF again, we're not opposed to IVF. You can deploy it when it makes sense.

But just getting the AMH number, being given a diagnosis and being told that that IVF or donor eggs are your only option is not serving you and you can deploy it when you see fit, when you take at least six months to be able to work on your health.

And I know if you're in your forties, you're like, there's no way I cannot try for six months. But I just see people that they, if they do continue to try, they could have a pregnancy loss. 'cause the body's not able to sustain it. That sets you back even more time. And then they keep going cycle after cycle and all those hormones on your body.

We don't know the long term side effects of pumping your body full of this piece. Like right now in your body. She's like yelling at you. Saying something [00:15:00] is wrong, something is not working, otherwise you'd be pregnant. And so if we do this in a systematic way, looking at the testing, not just throwing a bunch of super foods, reading books and listening to a podcast, but we need to be able to get your test, your results and invest in that piece.

Otherwise you're just throwing good money down the drain. Some of these biomarkers can be overlooked. The highest sensitivity, C-reactive protein, the homocysteine, the vitamin D, the ferritin, the celiac screening the autoimmune side of things. Those are underlying imbalances that can impact your egg quality and pregnancy success.

To share a success story we had. Heather came to see us and many people that we work with, they've been told that an their AMH is way, too low for their age. Heather came to see us and her, AMH was low.

She was told donor eggs were her only option. We found out she had thyroid dysfunction. She had low ferritin, low vitamin D. We looked at the inflammatory markers for her and we found hidden imbalances that were driving this low ovarian function and the nutrient deficiencies and the thyroid antibodies and, she went [00:16:00] on to do another IVF. Before that, she'd had three failed cycles, nothing had worked. Her partner, we also look at her partner too. His health matters. It's not just you over here making all these changes, and he's I don't know what I can do. Oh, there's lots he can do. He needs to get his semen tested.

He needs to look at the DNA fragmentation as well as all the blood work for him, making sure he is optimal. Not just wow, my sperm is amazing. I've got super swimmers. Okay, great. And he high fives the doctor and off he goes. No, we're making the diet changes together.

You're doing this together. It is not just him over here having pizza and beer and not knowing what to do. No, he's making the changes, setting a solid foundation, and we see infections passing back and forth between couples, so it's very important for him to look at his biomarkers. Do this in tandem with you.

You'll each have your own goals. We never want to coach our partner, nag him, tell him, take his supplements, do all this stuff, think that he's thwarting all your efforts. No, that does not serve anybody. We want to improve your intimacy. This journey can tear you apart as a couple.

We want to [00:17:00] deepen your intimacy and have you come together, set a strong foundation and work on your health together. Heather was able to go on after three failed IVFs before coming to see us. She went to do another IVF after working on her health for a period of time.

I think she was like eight months. She worked on her health and then she went back and it worked. And she had her daughter. You are not the AMH number. I know we all have that AMH. Back when I was diagnosed with POI at 28, they didn't even test AMH. But I definitely, knew the FSH numbers and knew that, donor eggs just gets stuck in your subconscious.

So most People, I talk to, they've got their AMH memorized. So you are not the number. We need to look beyond the number. It's important to know. We don't want to just not test it and not be blind to it. But it's not the whole picture. It's a signal. It's something deeper is going on.

And so when you look at things through a functional lens you can uncover those imbalances take action and improve your chances of pregnancy success. If you want to get my eyes on your specific situation, send me a message at hello@fabfertile.ca, subject line FERTILE, and we will [00:18:00] talk about some options.  Take care.

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How to Get Started With Functional Fertility Support

Book your call here to get your personalized plan and options to help improve pregnancy success either naturally or with IVF treatment. 

Check out our Fab Fertile functional fertility program here and learn how to improve AMH levels naturally.  We work with couples that have low AMH, high FSH, diminished ovarian reserve, premature ovarian insufficiency, and recurrent pregnancy loss.

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FAQs About AMH

Q. Can you get pregnant naturally with low AMH?

Yes. Studies show AMH is not a reliable predictor of natural conception.Many women conceive naturally with low AMH when underlying imbalances are addressed.

Q. Does AMH affect IVF success?

Low AMH often means fewer eggs retrieved, but egg quality matters more. Functional strategies can improve egg health before IVF.

Q. Can AMH be improved?

While AMH itself may not rise significantly, egg quality and ovarian function can improve through addressing inflammation, nutrients, and hormone balance.

Q. Is low AMH the same as early menopause?

No. Women with low AMH may still ovulate and conceive. Early menopause is when ovarian function stops completely.

Q. What lifestyle changes help low AMH?

• Anti-inflammatory nutrition (including gluten-free trials).

• Mitochondrial support (CoQ10, restorative sleep, stress reduction).

• Optimizing thyroid and nutrient status.

Key Takeaway

Your AMH number is important, but it’s not the final word. It’s a signal to look deeper at your health. By addressing underlying imbalances, you can improve egg quality, optimize fertility, and make informed decisions about IVF or other treatments.

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RESOURCES

📩 Get your free 10-day elimination diet plan! Email hello@fabfertile.ca with the subject line 10 DAY to receive your guide and take the first step toward reconnecting with your fertility.

📩 Get your free Thyroid & Fertility Guide! Email hello@fabfertile.ca with the subject line THYROID to receive your guide and learn the symptoms and exact steps to spot thyroid dysregulation, especially if you’ve been told you have low AMH.

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