Low AMH After 35: What Actually Predicts Pregnancy Success

If you’re over 35 with low AMH, you’ve likely been told some version of this: your numbers are your numbers, IVF is your only option, or there’s nothing else to do.
AMH provides information, but it does not tell the full story about your ability to get pregnant.

At Fab Fertile, we consistently see pregnancy success improve when the environment supporting the egg changes, even when AMH remains low.

Quick Scan: What Matters More Than AMH

If you want the short version, pregnancy success after 35 with low AMH is more closely linked to:

• Ovulation stability and cycle consistency

• Inflammatory load and immune balance

• Mitochondrial energy production

• Stress physiology, sleep, and circadian rhythm

AMH reflects quantity. Pregnancy depends on quality and signaling.

What AMH Actually Means (and What It Doesn’t)

AMH is a marker of ovarian reserve, not egg capability. It tells us how many follicles may be recruitable, not whether a single egg can mature, fertilize, and implant.

Key points:

• Low AMH does not equal poor egg potential

• AMH can fluctuate while fertility improves

• Natural conception relies on the environment, not egg yield

• IVF prioritizes quantity; natural conception prioritizes conditions

You are not trying to make 12 eggs respond. You are trying to develop one good egg.

AMH Does Not Predict Egg Quality or Natural Fertility

This study showed that AMH has a limited role in predicting embryo development or natural fertility, underscoring that AMH alone should not be used to assess reproductive potential.

Study: AMH has a limited role in predicting oocyte quality or in vivo reproductive potential - Nature Scientific Reports

Why IVF Often Fails With Low AMH After 35

Many women with low AMH are told IVF should work because standard labs appear normal. The problem is that the most disruptive factors do not show up on day-3 testing.

Common drivers of IVF failure we see include:

• Chronic inflammation

• Gut dysfunction and impaired nutrient absorption

• Immune activation

• Mineral depletion

• Mitochondrial stress

• Nervous system overload

• Poor sleep and circadian disruption

These factors directly affect egg development and embryo competence.

Predictor #1: Ovulation Stability

Pregnancy requires consistent hormonal rhythm, not perfect cycles.

What often gets missed:

• Anovulatory cycles

• Weak ovulation

• Short luteal phases

• Inconsistent temperatures

• Variable cervical fluid

You cannot develop a high-quality egg in an unstable ovulatory pattern.

Predictor #2: Inflammatory Load

Many women are inflamed without realizing it.

Common clues include:

• Skin issues such as acne or rashes

• Sinus congestion or chronic mucus

• Bloating, constipation, or loose stools

• Joint pain or headaches

• Endometriosis or autoimmune markers

Inflammation disrupts hormone signaling and follicular development. This is one reason IVF may fail, while natural cycles improve once inflammation is addressed.

Predictor #3: Mitochondrial Capacity

Eggs require energy. Specifically, ATP.

Signs mitochondrial function may be compromised:

• Fatigue or afternoon crashes

• Cracked lips or mineral deficiencies

• Poor stress recovery

• Exercise intolerance

You cannot supplement your way out of mitochondrial depletion. The conditions supporting energy production must be rebuilt.

Predictor #4: Stress Physiology and Circadian Health

This is often underestimated, especially in high-achieving women.

Common signs:

• Wired but tired

• Difficulty falling or staying asleep

• Waking unrefreshed

• Bruxism or jaw tension

• Reliance on caffeine

Stress physiology directly impacts ovulation strength, progesterone, and immune balance.

Sleep Disturbances Are Linked to Infertility & Poor Fertility Outcomes

A systematic review found that poor sleep quality, sleep disturbances, and circadian rhythm issues are associated with infertility and poor outcomes in fertility treatment, supporting your section on stress physiology and circadian health.

Study: Sleep disturbances and female infertility: a systematic review - BMC Women’s Health

What Improves Before Pregnancy Happens

Before conception, we consistently see:

• Smoother, more predictable cycles

• Improved cervical fluid

• Better sleep quality

• Reduced digestive symptoms

• Fewer energy crashes

• A calmer nervous system

These shifts tell us the ovarian environment is changing, even if AMH does not.

What the Research Supports

• Chronic inflammation alters follicular development and hormone signaling

• Mitochondrial dysfunction is linked to poor egg quality and embryo development

• Circadian disruption negatively affects reproductive hormones

• Immune activation plays a role in implantation failure and loss

These pathways are modifiable, even after 35.

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

00:00 – Low AMH After 35: Why AMH Does Not Predict Pregnancy Success

Why AMH reflects ovarian reserve, not egg capability or live birth outcomes.

01:10 – What AMH Really Means and Why One Good Egg Matters

Low AMH, follicle count, and why natural conception depends on environment, not quantity.

02:20 – Why IVF Often Fails With Low AMH and Diminished Ovarian Reserve

What standard fertility testing misses and why deeper health patterns matter.

03:30 – Inflammation, Digestion, and Immune Activation in Low AMH

How gut health, hsCRP, immune stress, and chronic symptoms affect egg development.

04:45 – Mineral Depletion and Mitochondrial Stress in Egg Quality

Why energy production, nutrient status, and mitochondrial health are foundational.

05:55 – Ovulation Stability and Hormonal Rhythm After 35

Weak ovulation, short luteal phases, irregular cycles, and why rhythm matters.

06:55 – Hidden Signs of Inflammation Clinics Often Overlook

Skin issues, joint pain, autoimmune patterns, digestive symptoms, and fertility.

08:00 – Stress Physiology, Sleep, and Circadian Health

Wired-but-tired patterns, insomnia, caffeine reliance, and hormone signaling.

09:05 – What Improves Before Pregnancy Happens With Low AMH

Cycle regulation, cervical fluid, sleep, digestion, energy, and nervous system calm.

10:10 – Next Steps After Failed IVF With Low AMH

How addressing underlying patterns can improve natural conception or IVF outcomes.

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Transcription

[00:00:00] Today's episode is called low AMH after 35. Why Pregnancy Success comes from addressing the underlying imbalances with our health. So if your AMH is low, you're over 35 and you've had a failed IVF cycle, or been told that IVF's your only option. This episode will give you clarity on what actually matters.

AMH tells you something, but it doesn't give you the full story. Excited for you to listen. 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 helping those with low AMH, high FSH, diminished ovarian reserve, premature ovarian insufficiency, and recurrent pregnancy loss using functional lab testing and personalized fertility strategies.

By the end of this episode, you'll know the four underlying patterns that predict pregnancy far more reliably than a MH, especially for women over 35 who haven't had success with IVF.

Thanks for being here. Make [00:01:00] sure you hit subscribe or follow, and if you know someone else who's on the fertility journey, please share this podcast with 'em.

We're talking about AMH. I feel like I'm banging on about this a lot. Really, AMH is the ovarian reserve, but not the capability. And so yes. Low AMH there's fewer follicles, but doesn't mean that pregnancy is not possible.

So it doesn't predict your egg potential. AMH can go up and down and pregnancy can still happen. So it's a poor predictor of live birth outcomes. We're looking at the environment for the eggs not hanging our hat on the AMH. And so you're not trying to make 12 eggs respond.

You're trying to develop one. Good egg. And so it only takes one. Why IVF fails for many women with low AMH. We work with a lot of type A professional women, a lot of stress. And they've typically been told that they have low AMH, but no one's dug deeper with their health.

No one's looking at all your biomarkers. [00:02:00] And you're told that IVF is your only option. IVF does not work when we haven't addressed all these different biomarkers. Obviously for some people it can, but if you're dealing with low AMH, diminished ovarian reserve, and you've gone through failed IVFs, it's not about you saving all your money for IVF thinking that's your only option without doing a deep dive in a targeted manner using testing.

So it's part of our Fab Fertile Method. We have access to testing. We ship it worldwide, North America, Europe the UK. Australia, New Zealand. To be able to figure out exactly is going on with your health. So IVF does not work when you've got high inflammation, we see that high sensitivity, C-reactive protein.

We want it below one. We see it elevated a lot. Digestion. If you've got known digestive issues. I have people telling me lifelong constipation. I've got IBS, bloating, burping, diarrhea. That is a clue. If you've got digestive issues. You can still have food sensitivities [00:03:00] and gut microbiome issues without known digestive issues.

But if you have digestive issues, you know for sure something's being missed. If you've got colds and flus and you are dragging your butt, someone sneezes on you next thing you know you're in bed for a while, is your immune system down? I have a whole guide called the immune system and how it relates with fertility, and so being able to boost up your immune system.

Send me a message at hello@fabfertile.ca, subject line IMMUNE, and I will send you that guide. There's specific things we can do to really get that, that improving. It's not I've got these colds and flus, cracked lips, mineral deficiencies, all this stuff, and we rush off to IVF. Minerals are depleted.

Maybe you've got little white specks on your nails from. From zinc deficiency or cracked lips, or you've got known low vitamin D and you're supplementing, but why is it low? Your mitochondria are stressed. So the mitochondria, the powerhouse of the cells, if all the stress and the toxins that are coming in that can be impacting the quality of your eggs your nervous system is [00:04:00] overloaded.

IVF's not going to look at that. If you feel impatient and frustrated and panicked, and worried and anxious, all these are normal. We need to be able to give voice to what's happening with this. Be able to calm our nervous system, because if our nervous system doesn't feel safe, it feels panicked and worried

because the REI just told you, your AMH is so low, it's falling off a cliff. That's not conducive to bringing in your child. We need to feel calm. We need to focus on our intuition. Our spirit baby. Waiting for us. Our faith in God. The universe, whatever works for you.

To he bring in some peace and some deep knowing, and that's what brings the calmness to you. And then you can be able to start making some of these changes. And if you've got poor sleep, if you got insomnia, you wake up in the middle of the night, going to bathroom multiple times, the early morning you could be waking up.

All these things are common, but again, not normal and not looked at if IVF is not working. Those are huge clues. All of them impact your egg development. And so we're not [00:05:00] anti IVF we're ProHealth. There's things we need to be able to do. So we need to be able to have consistent ovulation.

Not going to look at your anovulatory cycles, your weak ovulation, your short luteal phases, your inconsistent temperatures, your variable cervical fluid. So they may have noted some of that perhaps if you're tracking it, but they're pushing this with medication, so you can't develop a good egg in an unstable

hormonal rhythm. If you've got a high inflammatory load. Maybe you don't even know when you're inflamed, but you're dealing with some skin issues, hives ,acne. You've got psoriasis dermatitis, eczema, hives any kind of issues going on with the skin.

You have got digestive issues. Burping, bloating, constipation, diarrhea. You've got a known autoimmune issue. Hashimoto's and Celiac are ones that we see a lot, but we see all kinds of other autoimmune issues. With a low AMH, you're just getting a lot of colds and flu, so chronic mucus. Inflammation in the body.

Those are some clues. The [00:06:00] bloating, the joint pain. You shouldn't be like waking up and feeling like all your joints hurt. If you're feeling irritable, you've got ADHD you've got brain fog. If you're having any kind of joint issues, skin issues, digestive issues, autoimmune mood issues, those are clues, what is happening with inflammation in your body and being able to address that in a target manner.

So this can be a major reason that IVFs fails because we're not looking at the inflammatory issues. And that can impact your hormone signaling and follicle development. Mitochondrial capacity, so the eggs rely on ATP or energy and signs your mitochondria struggling, you're tired, the afternoon crash, you got cracked lips.

Used to have that all the time. So cracked lips are nutrient deficiencies. Mineral deficiencies. Slow recovery from stress. Everything has just got you wound up. Exercise intolerance. When you do it, you're exhausted the next day. So you can't supplement your way out of mitochondrial depletion.

You've gotta rebuild [00:07:00] the conditions and support the energy production, which is the health of your eggs. Good news. There's things that we can do along with this. Another one we see is the stress physiology or the circadian health. So this is a pattern we see in high achieving women and we typically will underestimate that.

So that wired, but tired. We keep going. Trouble falling asleep because we're just agitated or anxious. Waking up, feeling exhausted, heart palpitations.

Irritability, reliance on caffeine where we got to have the caffeine to get ourselves going in the morning, multiple cups. Those are some signs that your adrenals. Our whole thesis on this, is it actually early menopause or is it the adrenals that impact the thyroid impacts the AMH and the FSH and the follicle count.

It could be chronic stress you're dealing with, and that's going to impact your ovulation strength, your progesterone, your immune balance. Once you start to work on your health, so before conception, we [00:08:00] typically see regular cycles. Our goal is to help regulate your cycle.

It should come and be a non-event, cramps, irregularity, short cycles, all these. Short luteal phase all this stuff is a clue and so we need to be able to work on your cycle with these health issues. We see cycle improve improvements. We see people improving their cycle and getting a cycle back in the forties.

That's been gone for years. We see improved cervical fluid. We use trackers such as Inito or Mira, along with the basal body temperature and your cervical mucus. We see better sleep. The digestion improves. We see this all the time with our clients. So energy, digestion, sleep, mood, they come into the program.

Sometimes they're just blowing up our chat because you're feeling so agitated and you're trying to figure this out, and the pressure of all this is exhausting. So we're here to take the pressure off you to be able to answer those questions and help calm down the nervous system, get in with our mindset coach and be able to really visualize a positive path forward.

You and your partner [00:09:00] on the same page here, just feeling really calm. And hopeful about this because sometimes we can just feel in such a dark place and we need to honor where we've been, honor our path and grant ourselves some grace and be kind to ourself. Especially if you're Type A, we can just keep going.

I'm totally fine. Don't worry about me. I gotta worry about everyone else. We need to show ourselves some compassion and sometimes we could have compassion fatigue. People maybe have it for us. 'cause we've been on this fertility journey for years. We have it for ourself.

We're saying, oh, are you kidding? Another month of this, we keep going and keep going, right? And so we'd be able to nourish our body, calm the nervous system down and grant ourselves some grace. When we're looking at our blood sugar, it's not on this rollercoaster where you're irritable and your blood sugar's crashing. That's when improves pregnancy success, consistent energy.

We're just feeling good throughout the day. In a calmer nervous system, not this sense of panic. We can really hear our intuition. We can hear our faith. We're really leaning into that [00:10:00] and that's what tells us the ovarian environment is changing. So we've helped many people with low AMH high FSH go on to conceive naturally, or if they do go to IVF going on to improve their chances of pregnancy success.

So if you wanted to book a call, you can send me a message at hello@fabfertile.ca, subject line FERTILE. And I will give you some options to help. If this episode resonated with you, check out next week's episode where we're going to go deeper into poor egg quality, five patterns we see in women who still can get pregnant.

When this episode is live, I will link it here for you. Take care.

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FAQs

Can you get pregnant naturally with low AMH after 35?

Yes. We see this regularly when ovulation stability, inflammation, and stress physiology are addressed.

Does AMH ever improve?

AMH may increase, decrease, or remain stable. Fertility can still improve regardless of the number.

Should IVF be avoided with low AMH?

Not necessarily. IVF outcomes improve when underlying patterns are addressed first.

How long does it take to see changes?

Many women notice cycle and symptom changes within a few months, even before lab shifts.

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Key Takeaways

• AMH is one data point, not a fertility verdict

• Pregnancy success depends on the environment, not egg count

• IVF failure often reflects overlooked inflammatory, metabolic, or stress factors

• Supporting ovulation, mitochondria, and nervous system regulation matters

• Progress is often visible in symptoms before labs change

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