High AMH But No Pregnancy? Doctor Explains the Hidden Reasons

Table of Contents

• What is AMH?
• How AMH Affects Your Chances of Getting Pregnant?
• Challenges Related to High AMH Levels
• Conclusion

Anti-Müllerian Hormone (AMH) is one of the most important fertility markers used today. Many females check their AMH levels to understand their ovarian reserve, but the real question is, how does AMH actually affect their chances of getting pregnant?

AMH can offer the woman an assessment of her ovaries, which is helpful; however, it is not the only piece of information that determines if she can conceive or not. In this article, we present questions a woman should consider when she struggles to get pregnant despite having high AMH.

What is AMH?

The AMH hormone is secreted by small ovarian follicles found in your ovaries. An AMH hormone test is one method used to identify how many eggs you may have left in your ovaries (ovarian reserve).

• Higher AMH levels mean a larger number of eggs.

• Low AMH levels suggest lesser eggs remaining.

However, AMH measures egg quantity, not egg quality. And both are essential for successful conception.

AMH levels are measured in ng/mL. These levels usually peak in the mid-20s and gradually decline with age until menopause.

Dr. Neha Shriya, trusted fertility doctor in Gurgaon, Miracles Fertility & IVF Clinic, explains, “Women should not panic based on AMH alone. Even with low AMH, pregnancy is possible if egg quality is good. And even with high AMH, issues like PCOS or ovulation problems may prevent pregnancy.”

How AMH Affects Your Chances of Getting Pregnant?

High AMH Levels and Pregnancy

Elevated AMH levels often reflect a strong ovarian reserve. Women with high AMH often

• Have a high number of follicles in the ovaries.

• Respond well to fertility medications.

• Produce more eggs during IVF treatment.

In assisted reproductive treatments like IVF, AMH is useful in predicting how the ovaries may respond to stimulation. Higher AMH levels often result in retrieving more eggs during the cycle.

Challenges Related to High AMH Levels

Although women can have a lot of eggs, it does not guarantee they will be able to get pregnant. Many elements determining a woman’s ability to conceive are independent of the number of her eggs.

1. Polycystic Ovary Syndrome (PCOS)

Many of the reasons for women having a high level of AMH will be related to PCOS. Generally, it has been demonstrated that women who are suffering from PCOS regularly demonstrate higher than average levels of AMH.

High levels of AMH are seen in women with many very small follicles because these follicles produce and secrete large amounts of AMH compared to the release of an ovulated egg when an egg is mature and ready to be fertilized.

Women generally will have irregular and/or absent periods if they do not ovulate regularly or at all. Although women may have many follicles in their ovaries, they do not necessarily mature, therefore interfering with a woman’s ability to conceive and reducing her opportunities for natural conception.

2. Egg Quality Issues

AMH reflects the number of eggs but does not evaluate their quality. Factors such as age, insulin resistance, metabolic imbalance, and chronic inflammation can affect egg health. Even with a high AMH level, poor egg quality can reduce fertilization rates and embryo development.

3. No Ovulation

Ovulation is essential for conception. Without it, pregnancy cannot occur — no matter how high your AMH is.

Signs of No Ovulation:

• Irregular periods.

• No monthly cycle.

• Minimal cervical mucus.

• PMS symptoms without bleeding

Even with high AMH, anovulation will prevent egg release

4. Hormonal Imbalances Beyond AMH

AMH is only one hormone in a complex reproductive system. Others also influence fertility, such as

• FSH (Follicle Stimulating Hormone)

• LH (Luteinizing Hormone)

• Estrogen.

• Progesterone

• Thyroid hormones

• Prolactin

If any of these are out of balance, ovulation, egg quality, and implantation can be impacted.

5. Sperm Quality and Male Factor Issues

Fertility is a couple’s issue, not a woman’s alone.

Even if you have good AMH and ovulate regularly

• Low sperm count

• Poor sperm motility

• Abnormal sperm shape

• can all reduce the chances of fertilization.

If you are trying to conceive, both partners should get evaluated.

Read more: Conceiving Hope: A Step-By-Step Journey Through the IVF Process

6. Uterine or Structural Problems

Sometimes the issue is not the egg. It is the environment where the embryo needs to implant.

• Structural Issues Affecting Pregnancy

• Uterine fibroids.

• Polycystic-looking ovaries (PCOS)

• Endometriosis

• Scar tissue (Asherman’s syndrome)

• Blocked fallopian tubes

These can interfere with fertilization or embryo implantation, regardless of AMH.

7. Lifestyle and Other Hidden Factors

Even with good AMH

• Stress

• Smoking

• Poor diet

• Obesity or low body weight.

• Excessive caffeine or alcohol.

• Environmental toxins.

8. Advanced Maternal Age and Chromosomal Issues

Women over 35 may have high AMH but still experience:

• Fewer genetically normal eggs.

• Higher chance of miscarriage.

• Lower implantation rates.

• AMH does not predict chromosomal health.

9. Repeated IVF Failures Even with High AMH

High AMH may produce many eggs during IVF stimulation, but

• Embryos may be of poor quality.

• Implantation may fail.

• Repeated cycles may be needed.

• In such cases, doctors may recommend

• Genetic embryo testing (PGT)

• Adjusted stimulation.

• Donor eggs.

Conclusion:

AMH shows how many eggs are available, but it cannot guarantee pregnancy. Conception depends on ovulation, egg as well as sperm quality, uterine health, and overall well-being. If pregnancy is not happening even with high AMH, other factors may need evaluation. If your AMH levels are low or you are having trouble getting pregnant, speak with a fertility specialist near you at Miracles Healthcare for a personalized assessment and treatment plan.