AMH Level as a Predictor of Total Donor Eggs Retrieved during an IVF Cycle
When it comes to in-vitro fertilization (IVF), Anti-Müllerian Hormone (AMH) plays a critical role in helping predict how your ovaries might respond to stimulation. While it’s not the only factor determining success, AMH offers valuable insight into ovarian reserve—the number of eggs you have available – although not the quality of the eggs.
Understanding AMH and Its Relationship to Egg Retrieval
In IVF, there is a positive correlation between AMH levels and the number of eggs retrieved. Simply put, women with higher AMH levels generally produce more eggs during ovarian stimulation. However, AMH does not reliably predict egg quality or the chance of live birth per embryo transferred – factors that depend heavily on age and other biological conditions.
AMH Declines Naturally with Age
As women age, their egg supply—and therefore AMH—gradually declines. Women in their early 20’s typically have greater than 100,000 eggs, mostly of good quality. Unfortunately, as women age beyond 30 years old, the number and quality decrease dramatically. Women over 35 generally have less than 25,000 eggs, many, if not most, of poor quality. Additionally, it is important to note that while AMH in younger women is a good predictor of total eggs retrieved in an IVF cycle, a low number is NOT associated with reduced natural fertility. Here’s a general overview of average AMH ranges by age (measured in ng/mL):
| Age | Average AMH Level (ng/mL) |
| <25 | 3.0–5.0 |
| 25–30 | 2.5–4.0 |
| 30–35 | 1.5–3.5 |
| 35–40 | 1.0–2.5 |
| 40+ | 0.5–1.5 |
AMH and Egg Retrieval: Quantity vs. Quality
AMH is an excellent indicator of ovarian reserve and how a woman will respond to controlled ovarian stimulation.
- Higher AMH levels are linked to a greater number of retrieved eggs.
- Lower AMH levels (below 1.0 ng/mL) often predict fewer eggs and an increased risk of donor cycle cancellation due to a poor response.
- AMH levels of > 3.0 are used by some IVF clinics as a cut off for likelihood of success with donor cycles.
- Higher AMH levels (≥5–6 ng/mL) will typically indicate a high likelihood of a successful IVF donor cycle, but in some women raises the risk of Ovarian Hyperstimulation Syndrome (OHSS), a condition where the ovaries overreact to fertility drugs. Some research has shown that using a “dual trigger” shot approach, along with other preventative measures, is helpful in preventing OHSS while maintaining healthy egg development.
Proper treatment modulation by IVF specialists helps stimulation success while maximizing patient safety.
What the Research Shows
Numerous studies published in PubMed confirm that AMH levels are a strong and reliable predictor of the total number of eggs retrieved in an IVF cycle – including among egg donors.
Key Findings from Studies
- Strong correlation: Research shows a correlation coefficient between 0.5 and 0.68 between AMH and the number of retrieved oocytes.
- Predicting ovarian response: AMH helps clinicians anticipate whether a patient may be a low or high responder, tailoring medication doses accordingly.
- Egg donor screening: Many clinics use AMH thresholds (e.g., ≥2.0 ng/mL) to qualify egg donors, ensuring optimal retrieval numbers. Above 3.0 is preferred by some clinics. This latter opinion is supported by a study from Vale-Fernandes et al. (2023) which identified 3.2 ng/mL as predictive for retrieving fewer than 12 eggs—with 77% sensitivity and 60% specificity.
- Quantity vs. quality: While AMH predicts how many eggs may be retrieved, egg quality depends primarily on age, not hormone level.