Getting Pregnant with Low AMH

If you’re in your late 30s or 40s and have trouble getting pregnant with a healthy baby, you’ve probably been to the doctor for answers.  In fact, you may have been to several doctors by now - poked, prodded, and completely checked over.

One of the first tests a fertility doctor does is to check your blood test for your anti-Müllerian hormone (AMH) level.  Finding out that you have low AMH levels can be a devastating experience, leading to feeling almost hopeless in your quest to get pregnant.

After being diagnosed with low AMH, questions such as these may be running through your mind:

  • Can you still get pregnant with low AMH?
  • Can you improve your AMH level?
  • What is normal AMH level for your age?
  • Can you do IVF with low AMH?

First let’s start with some background information on AMH and then get to the answers for those questions.

What is AMH and when is it checked?

On the third day of your menstrual cycle, doctors look at your blood hormone levels to gauge your fertility potential.

One of the most important fertility hormones tested is your AMH level. Anti-Müllerian hormone (AMH) is a hormone secreted by the follicles in your ovaries. It is a way for doctors to estimate ovarian reserve and your chances for pregnancy with in-vitro fertilization (IVF).

Anti-Müllerian hormone is secreted by your ovarian follicle cells when they are just beginning to mature. The amount of AMH correlates to your ovarian reserve, or the number of follicle cells you have.

Each follicle is a fluid-filled sac that contains one immature egg.  During ovulation, the follicle releases a mature egg.

AMH levels are highest after puberty and fall over the course of your reproductive years.  When you reach menopause, the levels of AMH will be nearly undetectable. (study)

What is a normal AMH level?

Below is a chart showing what normal AMH levels are for adult women prior to menopause.

AMH Blood Level Interpretation
Over 3.0 ng/ml High (indicator of PCOS)
Over 1.0 ng/ml Normal
0.7 – 0.9 ng/ml Below Normal
0.3 – 0.6 ng/ml Low
Less than 0.3 ng/ml Very Low

What is a normal AMH level for your age?

AMH levels decline as you get older, so you may be wondering if your lower AMH is where it should be for your age.

A recent study found that for women who do not have PCOS, the average AMH levels were:

  • Ages 20-31 -- 2.35 ng/mL
  • Ages 32-34 -- 1.58 ng/mL
  • Ages 35-37 -- 1.30 ng/mL
  • Ages 38-40 -- 0.96 ng/mL
  • Ages 41-43 -- 1.05 ng/mL
  • Over 43 -- 0.67 ng/mL

The study also found that women with PCOS have abnormally high AMH levels. (study)  This is due to each of the small follicles producing more AMH than normal, thus driving the higher levels.(study)

Low AMH only correlates with fertility in women who are over age 30.  Low AMH in healthy women in their mid-20s do not predict reduced ability to get pregnant. (study)

Can you still get pregnant with low AMH?

Yes, you can still get pregnant with low AMH. It is just statistically more difficult, and this is why fertility doctors often suggest IVF or even an egg donor to increase your odds.

For women under age 35, the percentage who were able to get pregnant naturally with low or very low AMH levels ranged from 28 to 41%.(study)

Another study which included women aged 21 - 42 noted: “Natural conception was observed in women with a wide range of AMH-levels including women with undetectable serum-AMH.” (study)

So yes, natural pregnancy is possible with low AMH levels.

For many women, an egg donor is not an option due to financial costs or the desire to have her own biological child.  If that is you, read on to find out ways to help increase your odds of getting pregnant with low AMH.

Can you improve your AMH level?

If you are looking for natural, herbal-based solutions for low AMH, a few studies point to the efficacy of specific herbs in raising AMH levels.

Animal studies show that curcumin can increase AMH levels and protect against premature ovarian failure. (study)(study)(studyCurcumin is the main therapeutic compound found in turmeric.

Turmeric, a plant of the ginger family, is commonly used in cooking as a spice.  It can also be sliced to steep in hot water for a turmeric tea.

Buying fresh turmeric may initially be confusing because it looks very similar to ginger.  The main difference is its bright orange color as compared to the pale yellow of ginger.

Ginger Turmeric

Curcumin is available also as a supplement.

Traditional Chinese medicine (TCM) has been used for thousands of years to help with all kinds of ailments including problems with conceiving. Modern science is now beginning to test and understand how these herbal combinations work. 

An animal study tested a specific Chinese herbal formula and found that it significantly improved AMH levels in an animal model of diminished ovarian reserve. (study)

An overview of studies on Chinese herbal medicine found that it was both safe and effective for women dealing with infertility. (study)

A case study of a woman with low AMH and a history of failed IVF showed that in her case, a traditional Chinese herbal blend was effective in restoring ovulation. (study)

One of the herbs used in both formulas was Angelica sinensis, or dang gui. This is an herb that has been used in TCM for thousands of years to help with women’s reproductive disorders. An overview that analyzed a number of studies and clinical trials on TCM for infertility showed that Angelica sinesis was a component of almost all of the formulas used. (study)

Unlike supplements or Western herbs, Chinese herbal medicine is usually prescribed as a formula with many ingredients.  Because of the complexity of these formulas, working with a trained herbalist (often an acupuncturist with herbal training) is the best way to obtain the most benefit.

Are there any dietary interventions for improving AMH?

The research on this is scant, but a handful of studies help to answer this question.

Keep in mind that you want higher AMH levels (within normal range) to increase your odds of pregnancy.

Although many consider being overweight or obese may contribute to fertility issues, drastic weight loss is NOT recommended.  In fact, losing weight very rapidly, with bariatric surgery or restrictive dieting, has been shown in studies to lower AMH. (study)(study)(study)

If you have low AMH levels, this is not the time to go on a crash diet. Instead, a whole food, minimally processed nutritional plan including nutrient-dense proteins, healthy fats, and organic vegetables may help optimize your body for conception - and aid with gradual weight loss, if needed.

A dietary analysis of almost 300 women, aged 35-45, found as polyunsaturated fat increased (especially omega-6), the women’s AMH levels decreased.  (study)

The link to high omega-6 intake and decreased AMH levels could be due to those women eating higher amounts of fried food. Corn, soybean, and sunflower oil are all high in omega-6 fatty acids. One more really good reason to skip the drive-thru line and avoid fried foods!

Getting enough nutrients is important to AMH levels also. Conditions that decrease the absorption of nutrients, such as celiac and Crohn’s disease, are linked to lower AMH levels. (study)(study)

What else can I do to increase my anti-Müllerian hormone levels?

Research shows us several toxins that we are exposed to on a daily basis can decrease your AMH levels.

Several studies have linked higher levels of BPA to lower AMH levels.

One study found that most of the women participants had BPA in their body, and that those in the top half of BPA levels had about a 22% decrease in AMH. (study)

Another study found that 100% of the participants had detectable BPA in their body. This study also linked increased BPA with decreased AMH. (study)

Avoiding BPA completely can be difficult, but even reducing your exposure level partially could make a difference.  Common sources of BPA include:

  • eating canned foods packaged with linings that contain BPA
  • eating foods packaged in plastics that contain BPA
  • absorbing BPA through skin contact with some thermal printed cash register receipts

Pesticide exposure has also been linked with decreased AMH levels. A study of women in China found that higher levels of organochloride pesticides were associated with lower anti-Müllerian hormone.(study)

Another study involving women in rural South Africa found that exposure to pyrethroid pesticides was associated with a 25% decrease in AMH levels. (study)

Choosing organic vegetables and fruits – and avoiding most packaged foods – will help you to decrease your pesticide exposure.

Another lifestyle factor that you can control is staying active. Moderate exercise was shown in a study to increase AMH levels.(study)

A walk after dinner with your loved one each evening is an easy way to stay active, wind down from your day, and connect with your significant other.

Titanium dioxide nanoparticles, which can be found in sunscreens and other cosmetics, have been shown to decrease AMH levels in animal studies. (study)(study)

Instead of slathering chemical-laden sunscreens, use hats and light clothing to protect your skin.  Keep in mind though that some direct sun exposure everyday is needed for optimal vitamin D production.

6 Science-backed steps that you can take today to raise low AMH levels:

  1. Eat whole, unprocessed, nutrient-dense foods such as grass-fed meat, wild fish, pasture-raised eggs, organic vegetables, and healthy fats.
  2. Avoid fried foods and limit omega-6 oils such as corn, soybean, and sunflower oils.
  3. Add in curcumin, either as a supplement or in your foods each day.
  4. Avoid BPA exposure as much as possible -- don’t use plastic containers for warming foods, check the labels to make sure your canned foods are BPA free, and avoid handling thermal printed receipts as much as possible.
  5. Stay away from pesticides such as pyrethroids, which are found in many household insecticides. Choose organic fruits and produce as much as possible.
  6. Check to see if your sunscreen or cosmetics contain titanium dioxide on the EWG website.

If you are dealing with low AMH levels, stack all of these action steps together. This is the time to go all in -- clean up your diet, avoid pesticides and toxins, and add in the right nutrients!