What does Low AMH Mean for Fertility?
I have seen so many people who feel overwhelmed and anxious after being told that they have low AMH. They have concerns and questions like:
Will I go through menopause earlier than expected?
How does this impact my ability to conceive now or in the future?
Should I freeze my eggs while I still have some?
If you're facing these concerns, you’re not alone. This guide will help you understand what low AMH really means, what it doesn’t mean, and how you can take proactive steps to support your fertility.
Firstly- What is AMH?
AMH is a hormone produced by the small follicles in your ovaries. It serves as a marker of ovarian reserve, so it provides a general idea of how many eggs remain. However, AMH does not predict how easy or difficult it will be for you to conceive. I have seen people with low AMH get pregnant really quickly, while those with high AMH may still experience fertility challenges.
AMH can provide insights into ovarian reserve, but it doesn't determine the quality of your eggs or overall fertility potential.
Since egg count naturally declines over time, the focus should be on egg quality, which can be influenced by lifestyle, nutrition, and other modifiable factors.
Signs & Symptoms of Low AMH
In most cases, low AMH does not cause symptoms. It’s usually discovered through fertility testing. However, some people with low AMH may experience:
Irregular or missing periods (which can sometimes be misdiagnosed as PCOS)
Difficulty conceiving due to irregular ovulation or low estrogen levels
Early menopausal symptoms (hot flashes, night sweats, mood swings, low libido)
If you're experiencing these symptoms, it’s best to discuss them with your doctor to explore potential causes and solutions. Should everyone be testing for low AMH? Not necessarily. As I mentioned it doesn't impact directly on your fertility but if falling pregnant is taking longer for you then it can be helpful in understanding what may be contributing.
What Causes Low AMH?
Several factors can contribute to low AMH, including:
Age (AMH naturally declines with time)
Genetics
Autoimmune conditions
Medical treatments (chemotherapy, radiation, certain surgeries)
Endometriosis (especially if ovarian surgery has been performed)
Primary Ovarian Insufficiency (POI) (unexplained premature ovarian aging)
Additionally, vitamin D deficiency can falsely lower AMH levels. Studies have shown that correcting vitamin D levels can lead to a 13-18% increase in AMH levels in deficient individuals (Irani & Merhi, 2014).
What You Need to Know About AMH Levels
1. You Cannot Increase Your Egg Count
Unfortunately, no supplement or diet can increase the number of eggs you have. However, you can focus on improving egg quality, which is crucial for conception and healthy pregnancy outcomes. There is also some evidence that mediterranean dietary patterns, adequate omega 3 intake, an antioxidant rich diet, and fish intake can help to prolong reproductive years and delay menopause- however the evidence on this is still evolving.
2. Biotin Supplements May Affect AMH Results
Biotin (vitamin B7), commonly found in hair, skin, and nail supplements, can interfere with AMH tests, sometimes causing inaccurate results. If you're taking biotin, inform your doctor before testing.
3. AMH is Only Part of the Fertility Picture
While AMH gives an estimate of ovarian reserve, it doesn’t assess whether conception will be easy or difficult. Many factors influence fertility, including ovulation, egg quality, hormone balance, uterine health, and sperm health.
How to Support Egg Quality with Low AMH
Since quantity can’t be changed, the focus should be on improving egg quality. Research has identified several key dietary and supplement strategies to enhance egg quality:
Nutrients & Supplements Supported by Research:
Coenzyme Q10 (CoQ10) – A study published in Aging Cell (2018) found that CoQ10 supplementation improved ovarian response and mitochondrial function in aging eggs (Bentov et al., 2018). The dose and type is important here- make sure to seek advice on this before supplementing to ensure you get the maximum benefit.
Omega-3 Fatty Acids – Research from Fertility and Sterility (2019) showed that women with higher omega-3 intake had improved embryo quality and longer reproductive lifespan (Hammiche et al., 2019). Your dose of this is also important- ideally we are looking at omega 3 intakes of 2000-3000mg/ day at least plus high content of EPA and DHA within these.
Vitamin D – A meta-analysis in Human Reproduction (2020) found that sufficient vitamin D levels were associated with better IVF outcomes and embryo quality (Pacis et al., 2020). It's important that you don't just randomly supplement though as supplementation should be in direct relation to your vitamin D level.
Resveratrol – Found in grapes and berries, resveratrol has been shown in animal studies to enhance ovarian function and slow ovarian aging (Reproductive Sciences, 2017) (Liu et al., 2017).
There is some evidence that Myo-inositol can benefit egg quality and IVF success rates, according to studies in Gynecological Endocrinology (2015) (Unfer et al., 2015). This one is important to seek advice on as it doesn't work for all individuals so doesn't necessarily need to be included as part of your regimen.
The key with supplements for egg quality are around protecting eggs from harm at the same time as counteracting oxidative stress through antioxidants. My advice is that instead of taking a random concoction of everything at whatever dose you see online- just get an expert to write a supplement plan for you! You can learn more and book for my fertility supplement session here.
Dietary Patterns That Support Egg Quality:
Mediterranean Diet – A 2018 study in Human Reproduction found that women who followed a Mediterranean-style diet had a 65% higher chance of successful IVF outcomes compared to those who didn’t (Karayiannis et al., 2018).
Plant-Rich, Antioxidant Diet – Antioxidant-rich foods (berries, leafy greens, nuts, seeds) help combat oxidative stress, which damages eggs over time (Jin et al., 2019).
Protein Balance – Getting adequate protein from high-quality sources (wild-caught fish, eggs, legumes) has been linked to better ovarian function (Chavarro et al., 2018).
Other Health Considerations with Low AMH
Beyond fertility, low AMH may have implications for other aspects of health, including:
1. Menopause Timing
Studies indicate that lower AMH levels are associated with earlier menopause, but AMH alone does not predict the exact timing of menopause (Depmann et al., 2018).
2. Bone Health
Low AMH can affect estrogen levels, which play a role in bone density. Maintaining bone health through weight-bearing exercise, calcium, and vitamin D is crucial (Szendei et al., 2020).
3. PCOS & AMH
While low AMH is linked to diminished ovarian reserve, PCOS is often associated with high AMH levels due to increased follicle numbers. If you have irregular cycles and low AMH, further evaluation is needed to rule out other conditions (Dewailly et al., 2016).
What’s Next if You Have Low AMH?
A low AMH result doesn’t mean you won’t be able to conceive. Many people with low AMH still get pregnant naturally or with fertility support.
Here’s what you can do next:
Talk to your doctor or fertility specialist about your individual situation and options.
Focus on egg quality through nutrition, lifestyle, and targeted supplements.
Seek professional guidance to create a personalised fertility strategy. Every fertility journey is unique and having support from experts is invaluable.
Schedule your 1-1 Fertility Intensive Session HERE.
Need Help Optimising Your Fertility?
If you're looking for expert guidance on nutrition and lifestyle strategies to support fertility and egg quality, book a consultation with me, certified fertility dietitian. Together, we can develop a plan tailored to your unique needs and goals. Learn more about working with me and schedule your session here.
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