AMH Age Fertility Calculator — PCOS & Ovarian Reserve
AMH (Anti-Müllerian Hormone) is the most widely used marker to assess ovarian reserve — the number and potential quality of available eggs. In PCOS, AMH occupies a particular position: it is often 2 to 3 times higher than in women without PCOS of the same age. This does not mean "hyper-fertile" — it reflects the large number of antral follicles characteristic of PCOS.
This tool lets you interpret your AMH level while accounting for your age, with an interpretation specific to the PCOS context. It also includes a converter between the two common units (pmol/L and ng/mL).
Your AMH values
Conversion: ng/mL × 7.14 = pmol/L
Interpretation is adjusted for your age.
AMH and PCOS: understanding the connection
In PCOS, the ovaries contain an abnormally high number of small antral follicles (between 2 and 9 mm in diameter). This is the ultrasound definition of polycystic ovarian morphology. Each antral follicle secretes AMH — so more follicles, more AMH in the blood.
According to a study published in Human Reproduction Update (2022), women with PCOS have on average 2.8 times higher AMH than those without PCOS of the same age. The ESHRE (European Society of Human Reproduction and Embryology) updated its criteria in 2023 to include an AMH threshold ≥ 3.4 ng/mL (≈ 24.3 pmol/L) as an alternative criterion to the antral follicle count (AFC) on ultrasound for PCOS diagnosis.
| AMH value (pmol/L) | General category | PCOS interpretation |
|---|---|---|
| < 0.7 | Very low | Unusual in PCOS — check for recent OCP use, assay error |
| 0.7–3.5 | Low | Low for PCOS — consider complete assessment |
| 3.5–28 | Normal | May be compatible with or without PCOS depending on other criteria |
| 28–85 | Elevated — PCOS range | Typical of PCOS. Reflects high AFC. Not a fertility problem in itself. |
| > 85 | Very high | Severe PCOS forms — significant OHSS risk in IVF, adapted protocols required |
AMH norms by age group
AMH naturally decreases with age, at the rate of ovarian reserve depletion. This is why interpreting an AMH value must always account for the patient's age.
| Age | Indicative norm (pmol/L) | Indicative norm (ng/mL) |
|---|---|---|
| 20–25 years | 15–40 | 2.1–5.6 |
| 26–30 years | 12–35 | 1.7–4.9 |
| 31–35 years | 8–25 | 1.1–3.5 |
| 36–40 years | 4–15 | 0.6–2.1 |
| 41–45 years | 1–8 | 0.1–1.1 |
Sources: Broer SL et al., Fertility and Sterility (2014); La Marca A et al., Human Reproduction Update (2010). These are general reference values — your laboratory may use slightly different references depending on the assay kit.
AMH, PCOS, and fertility implications
PCOS is the most common cause of anovulatory infertility (absence of ovulation), but it is not synonymous with permanent infertility. The vast majority of women with PCOS can conceive — often with medication to induce ovulation.
An elevated AMH in PCOS is therefore a marker of the condition, not a negative fertility prognosis marker. However, it is an important indicator for adapting protocols in IVF:
- OHSS risk (ovarian hyperstimulation syndrome): elevated AMH is the primary predictor of OHSS. IVF teams adapt protocols (gonadotrophin doses, trigger type) accordingly.
- Number of eggs retrieved: elevated AMH is associated with more eggs at retrieval, but not necessarily better embryo quality.
- Ovulation induction: for women with PCOS seeking to conceive naturally, letrozole is now the first-line treatment recommended by ESHRE (2023), ahead of clomiphene.
What can affect your AMH result
- Oral contraception (the pill): reduces AMH by 30–50%. Ideally, stop the pill 3 months before a reference measurement.
- Cycle day: AMH varies little across the cycle (unlike FSH), but some studies report slight variation.
- Assay method: Elecsys, Beckman, and Access kits give slightly different results. Always compare using the same laboratory.
- Body mass index (BMI): obesity tends to slightly reduce measured AMH.
- Smoking: smoking is associated with reduced ovarian reserve and lower AMH.
- Previous ovarian surgery: any cystectomy or ovarian resection can permanently reduce AMH.
Frequently asked questions
Why is AMH often elevated in PCOS?
In PCOS, AMH is typically 2 to 3 times higher because the ovaries contain an increased number of antral follicles. Each follicle produces AMH. This is not a sign of hyperfertility but a biological marker of PCOS, according to ESHRE guidelines (2023).
Can AMH alone diagnose PCOS?
No. PCOS diagnosis remains clinical and requires at least two Rotterdam criteria: oligo-anovulation, hyperandrogenaemia, polycystic ovarian morphology. AMH can be integrated as an alternative to ultrasound AFC since ESHRE criteria 2023.
Does the contraceptive pill affect AMH?
Yes. The combined oral contraceptive pill reduces AMH by 30–50%. This effect reverses within 3 months of stopping. Always report your contraceptive use when having AMH measured.
How often should AMH be measured in PCOS?
AMH is stable across the cycle, measurable on any day. Annual testing is sufficient for follow-up without an immediate pregnancy plan. When planning conception, a complete fertility assessment (AMH + AFC + FSH + estradiol) is recommended.
Does very high AMH in PCOS mean better fertility?
Not necessarily. Many follicles does not mean better fertility as they are often "blocked" in development. In IVF, very high AMH is associated with increased OHSS risk — protocols must be adapted accordingly.
What is the difference between AMH in pmol/L and ng/mL?
Two different units for the same hormone. Conversion: ng/mL × 7.14 = pmol/L. UK labs often use pmol/L; US labs often use ng/mL. Always check the unit on your lab result before interpreting it.