Slavian Bumbu: A Low AMH Is Not an Infertility Diagnosis
Slavian Bumbu, Founder of RLS RAIO Women’s Health Project, shared on LinkedIn:
” ‘Doctor, my AMH is low. Can I still have a baby?’
I hear this question increasingly often from women with no known infertility who arrive with a laboratory result and considerable anxiety.
AMH is an indirect marker of ovarian reserve. It is not a reliable standalone test of natural fertility.
What does the evidence tell us?
- In a prospective study of 750 women aged 30–44 without known infertility, the estimated probability of conception within six cycles was 65% in women with low AMH and 62% in those with normal AMH, with no statistically significant difference (Steiner et al., JAMA, 2017).
- A more recent cohort of 3,150 women identified a modest but statistically significant association between AMH below 1 ng/mL and reduced fecundability (adjusted HR 0.77; Nelson et al., Fertility and Sterility, 2024). An association of this size does not translate into a reliable fertility prediction for an individual woman.
- ACOG advises that AMH generally should not be used to predict future fertility in women without known infertility.
A low AMH is not an infertility diagnosis. A normal AMH should not create false reassurance about age-related fertility decline.
AMH has genuine clinical value when it informs management: ovarian stimulation, fertility preservation, assessment before ovarian surgery or selected evaluations of ovarian function.
The key clinical question is not simply what the AMH value means, but whether it changes our clinical decisions.
I have written an evidence-based guide addressing the questions women most frequently ask about this test.
Colleagues, how do you approach counseling when an AMH result generates anxiety rather than clarity?”

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