Why AMH ≠ Egg Quality
Written by Helen Yang, PhD
Founder & CEO, OvaVision
You’ve probably heard it from a doctor — or worse, seen it on a test result:
“Your AMH is low.”
Cue panic. Because somewhere along the line, AMH became shorthand for your fertility, a single number that seems to define your entire reproductive future.
Even for someone who works with fertility hormones and understands the science behind AMH, that moment can still hit hard. I remember the first time I saw my own number. My heart sank. It didn’t matter that I knew AMH isn’t destiny, the fear was instant.
It took real effort to remind myself of the facts: low AMH doesn’t mean your reproductive future is bleak. And it’s just one number, far from the full story.
🧪 So what is AMH?
Before you can understand AMH, you first have to understand the concept of ovarian reserve.
You’re born with all the eggs you’ll ever have, and you lose some every month.
At birth, the average female has around 1 to 2 million eggs. By puberty, only 300,000 to 500,000 remain. That’s not because anything went wrong. It’s how the system works. Even in childhood — and even before you were born — your body begins quietly selecting small batches of eggs. Most don’t make it, and they just break down naturally.
It might sound wasteful, or even insane, but this isn’t a flaw. Instead, it’s a built-in filtering system. Your body discards eggs that don’t meet the standard, long before ovulation ever starts.
Starting at puberty, each month, a group of eggs is recruited. Usually, just one reaches full maturity and is ovulated. The rest are discarded.
The eggs that haven’t yet been recruited — the ones still in your ovarian reserve — live inside structures called follicles. These follicles release the hormone known as Anti-Müllerian Hormone (AMH) — and that’s what the AMH blood test measures. The more eggs you have left, the more follicles you have, and the higher your AMH tends to be.
It’s useful. But it’s often misunderstood.
🚫 What AMH Doesn’t Tell You
This is where most of the confusion starts.
AMH has a clear biological role, but it’s often misunderstood as a fertility score, or worse, a diagnosis. It’s not.
Here’s what AMH does not tell you:
It does not determine whether you’ll need fertility treatment
It does not predict your chances of getting pregnant, naturally or with IVF
It does not indicate your risk of miscarriage
It does not measure egg quality
And it does not tell you how fertile you are
Plenty of women with low AMH conceive naturally, with no or minimal intervention.
And plenty of women with high AMH struggle to conceive, especially when egg quality is impacted, or when conditions like PCOS are involved.
AMH is not a verdict. It’s one number, not your future.
😵💫 So Why Is Everybody So Obsessed with AMH?
Clinics originally started using AMH to plan ovarian stimulation protocols for IVF and egg freezing. Before AI tools existed, doctors needed a way to estimate how your ovaries might respond, how many eggs could be retrieved, and how to dose medications accordingly (more on this in a future Fertility Fridays article).
That’s still what it does best. It was never meant to predict your fertility, just to support treatment planning.
But over time, AMH took on a new role: a kind of proxy for fertility, often interpreted in isolation.
So why did it catch on?
Because compared to everything else we’ve got, AMH is unusually simple.
It can be measured any day of your cycle.
It’s relatively stable.
It’s available through a simple blood test. And now, even at-home test kits exist.
It’s much easier to interpret compared to FSH or estradiol (E2)
AMH is simply the best fertility test we have. But that doesn’t mean it should be the gold standard. It just means better tools haven’t been invented yet.
The real problem is what happens next: people are handed a number with no or little context. And that number often leads to questions like:
Should I freeze my eggs?
Should I panic?
Am I behind?
AMH was never meant to guide your reproductive decisions. It shouldn’t be the reason you rush to egg freezing or fertility treatments, or the reason you lose sleep.
For this exact reason, AMH is a hotly debated topic among fertility experts and clinical guideline makers. Eespecially when it comes to offering it to people not pursuing IVF or egg freezing. Because without real context, it often causes more anxiety than clarity.
Fertility is far too complex to be represented by a single number (at least for now). AMH is just one piece of a much bigger puzzle.
💡 What’s the Takeaway?
Here’s what AMH can help with, and where it stops:
Ovarian reserve: AMH gives you a rough estimate of how many eggs you might have left.
Treatment planning: Doctors may use it to guide IVF or egg freezing medication protocols.
Menopause timeline: A lower AMH might suggest you’re closer to perimenopause or menopause, but this is more of a general trend than a precise forecast.
That’s about it.
There’s not much AMH can tell you beyond that, and it definitely doesn’t define your fertility.
Fertility and hormone testing can be confusing. We get it. It’s normal to have questions, and it’s easy to feel overwhelmed.
That’s why, at OvaVision, we’re building tools to give you clearer insights and help you navigate your fertility journey with confidence.
About the Author
Dr. Helen Yang, PhD, is a Harvard-trained scientist with years of experience in cutting-edge fertility research. She founded OvaVision to bring people AI-driven insights into their fertility journey, with a focus on clarity, emotional support, and science that actually makes sense.
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