Low AMH & Fertility: What Your Numbers Actually Mean

If you're reading this, you've probably just received a low AMH result. Maybe your doctor used words like "diminished ovarian reserve." Maybe there was urgency in her voice. Maybe you left the appointment feeling like your options had suddenly narrowed.

That number is not the whole story.

We've worked with hundreds of women with low AMH over the past two decades. Many of them are now mothers. Understanding what this number actually means, and what it doesn't, changes everything about how you move forward.

What Does Low AMH Mean?

AMH (anti-Müllerian hormone) is produced by the small follicles in your ovaries. It estimates your ovarian reserve, meaning the quantity of eggs you have remaining. When AMH is low, doctors often use the term "diminished ovarian reserve" or DOR.

The key word is quantity.

AMH tells us something about how many eggs are in your reserve. It tells us very little about the quality of those eggs. And egg quality, not quantity, is what determines whether you can conceive and carry a healthy pregnancy.

A woman with low AMH can have excellent egg quality. A woman with high AMH can have poor egg quality. The number doesn't distinguish between these scenarios.

This is why AMH is not a fertility test. It's an ovarian reserve test. These are different things, and the distinction matters.

What Low AMH Doesn't Tell You

Low AMH does not mean you can't get pregnant. Women with very low AMH conceive every day, both naturally and with treatment.

It doesn't tell you your egg quality, which is the factor that matters most for conception and healthy pregnancy. No blood test measures that directly.

It doesn't tell you how much time you have. AMH fluctuates from month to month and even from lab to lab. A single snapshot doesn't reveal how quickly your reserve is declining or when you'll reach menopause.

It doesn't predict IVF success. AMH helps predict how you'll respond to stimulation medications, but it doesn't predict whether retrieved eggs will become embryos or babies.

When doctors see low AMH, they often recommend moving quickly to IVF. This isn't necessarily wrong. If your reserve is diminishing, time does matter. But the urgency can obscure an important truth: low AMH means you may have fewer eggs to work with. That's different from saying you can't conceive.

Can You Get Pregnant with Low AMH?

Yes. Women with low AMH get pregnant naturally, and they get pregnant with treatment.

Low AMH means you may be releasing fewer eggs over time, so natural conception may take longer. It means timing matters more. It means you want to optimize conditions so the eggs you do release have the best chance.

But if you're ovulating, you're releasing an egg each month. That egg can be fertilized. That fertilized egg can implant and become a baby. Many women with low AMH conceive without any intervention at all.

Studies confirm this. A landmark 2017 study published in JAMA followed 750 women ages 30-44 with no history of infertility. The researchers found that women with low AMH had an 84% chance of conceiving within 12 months compared to 75% in women with normal AMH. Low AMH did not predict reduced fertility.

A 2021 meta-analysis published in Reproductive Biology and Endocrinology, reviewing 11 studies and over 4,000 women, concluded that AMH has weak predictive value for natural pregnancy. A decreased AMH level does not represent decreased natural fertility in young or older women.

If you've been trying for six months or more with low AMH, it makes sense to get a full fertility workup to rule out other factors. But don't assume IVF is your only path based on this number alone.

How to Improve Fertility with Low AMH

If AMH measures quantity and you can't change quantity, what can you change? Quality.

Research published in Nature Aging in 2024 demonstrated that egg quality depends heavily on the surrounding follicular environment. The study found that aged oocytes cultured within young follicles showed significantly improved rates of maturation, blastocyst formation, and live birth. The environment where eggs develop, not just the eggs themselves, determines much of their quality.

This environment is influenced by factors within your control.

Inflammation. Chronic inflammation creates oxidative stress that damages developing eggs. Reducing inflammation through diet, lifestyle, and treatment can improve the environment where your eggs develop.

Blood flow. Your follicles need oxygen and nutrients delivered through good circulation. Acupuncture has been shown to increase blood flow to the ovaries and uterus. Research in the Journal of Endocrinological Investigation demonstrated measurable improvements in ovarian blood flow following acupuncture treatment.

Hormonal balance. The hormonal environment during the 90-day window of egg development influences how eggs mature. Supporting this environment gives your eggs better conditions to develop in.

Sleep. Poor sleep increases inflammation, disrupts hormone production, and affects cellular repair processes. Most women we see with low AMH are not sleeping well, and addressing this makes a measurable difference.

Stress. Chronic stress affects hormonal signaling and creates inflammation. The women who do best with low AMH are often those who find ways to genuinely settle their nervous systems, not just manage their stress but actually feel different in their bodies.

Digestion. Your digestive system affects nutrient absorption, inflammation levels, and estrogen metabolism. If you have digestive symptoms, they may be affecting your fertility in ways that aren't obvious.

The women with low AMH who conceive are usually the ones who focus on these factors rather than fixating on the number itself.

Low AMH and IVF: What to Know

If you're pursuing IVF with low AMH, the goal is to optimize the quality of the eggs you do produce.

The egg that will be retrieved three months from now is developing right now. What you do during this window influences how that egg matures. This is why preparation matters, even when you feel pressure to move quickly.

We work with many women with low AMH who are preparing for IVF. The focus is on reducing inflammation, improving blood flow, supporting hormonal balance, and regulating the nervous system. We often see women respond better to stimulation after a few months of preparation: retrieving more eggs than predicted, producing better quality embryos, having better outcomes than previous cycles suggested they would.

We also support women during IVF cycles with acupuncture before and after retrieval and transfer. For more on this, read our article on acupuncture and IVF.

When you have low AMH, you may not be able to increase your quantity. But you can create the best possible conditions for the eggs you have. We've seen women retrieve three eggs and get two healthy embryos. We've seen women retrieve fifteen eggs and get none. The difference is quality.

What to Do After a Low AMH Diagnosis

If you've been diagnosed with low AMH, here's where to focus your energy.

Understand what you're working with. AMH is one data point. Make sure you have a complete picture: FSH, estradiol, antral follicle count, and assessment of other factors that affect fertility. Don't make decisions based on one number.

Focus on egg quality. Since quantity is what it is, put your energy into optimizing the environment where your eggs develop. This means addressing sleep, inflammation, stress, and overall health. Read our article on how to improve egg quality for specific guidance.

Consider your timeline thoughtfully. If your reserve is low, time does matter. But "act fast" doesn't have to mean "skip preparation." Even two to three months of focused preparation can make a meaningful difference in egg quality and IVF outcomes.

Get support. This is emotionally difficult. The fear and grief that come with a low AMH diagnosis are real. Working with practitioners who understand both the medicine and the emotional experience can help you navigate this without being consumed by it.

What This Looks Like in Practice

A woman came to see us at 41 with an AMH of 0.2. Her reproductive endocrinologist had been blunt: IVF immediately, and even then the odds weren't good. He mentioned donor eggs as a likely next step.

She'd already done two IVF cycles. The first retrieved two eggs, neither fertilized. The second retrieved three eggs, one embryo that stopped developing on day two. Her doctor attributed it to her age and reserve.

When I talked with her, she was scared but also curious. She wanted to understand what else might be going on. She told me she'd had digestive issues for years: bloating, acid reflux, food sitting heavy in her stomach. She had eczema on her hands that flared with stress. Her sleep was fragmented, not the classic 3am waking, but light sleep where she never felt like she went deep. She was a perfectionist, the kind of person who held tension in her jaw and shoulders without realizing it.

Her AMH was very low. But there was more to her picture than that number.

We worked together for three months before her next cycle. We focused on her digestion first because it was affecting everything: her nutrient absorption, her inflammation levels, her energy. We used acupuncture twice weekly and Chinese herbs daily. We worked on the tension patterns in her body, helping her nervous system learn to actually let go rather than just managing stress.

Her digestion improved significantly. The eczema calmed down. She started sleeping more deeply. She said she felt different in her body, less clenched, more open.

Her third IVF cycle retrieved five eggs. Four fertilized. Two made it to blast and were chromosomally normal.

Her first transfer resulted in her daughter, born when she was 42.

Her AMH was the same as it had been. What changed was the environment those eggs developed in: less inflammation, better nutrient delivery, a nervous system that wasn't constantly braced. Her eggs had better conditions to work with, and they responded.

Read stories from women we've worked with →

Your Next Step

If you've been diagnosed with low AMH and want to understand your options, we can help. Whether you're trying naturally or preparing for IVF, we'll look at the full picture and create a plan focused on optimizing egg quality and supporting your body.

Low AMH is information, not the whole picture. What you do with that information matters.

Learn more about our Fertility & Health path or contact us at 212.432.1110 or info@fafwellness.com.