A serum Anti-Müllerian Hormone (AMH) level of 0.2 pmol/l indicates a very low ovarian reserve, which is predictive of a low ovarian response to gonadotrophin stimulation in assisted reproductive techniques (ART) such as IVF.
According to UK guidelines, an AMH level of less than or equal to 5.4 pmol/l measured by the Beckman–Coulter assay is associated with a poor ovarian response, typically fewer than 4 oocytes retrieved, and possibly cycle cancellation during IVF treatment. A value as low as 0.2 pmol/l is significantly below this threshold, suggesting markedly reduced ovarian reserve and therefore lower chances of successful stimulation and oocyte retrieval through ART.
Regarding natural conception, while AMH is a marker of ovarian reserve and can predict ovarian response to stimulation, it is not a direct predictor of the ability to conceive naturally. Age remains the primary initial predictor of natural conception chances. However, very low AMH may correlate with diminished ovarian reserve and thus likely reduced fertility potential overall. Hence, a value of 0.2 pmol/l indicates reduced fertility potential both naturally and with assisted reproduction, but it does not definitively exclude the possibility of natural conception.
In summary, an AMH level of 0.2 pmol/l is indicative of very low ovarian reserve and predicts a poor response to fertility treatments like IVF, and may imply reduced natural fertility potential, warranting specialist fertility assessment and counseling. Clinical decisions and prognosis should integrate AMH results with other factors such as age, menstrual history, and other relevant investigations.
NICE CG156