You got the call. Your labs came back and you have numbers: FSH 11.2, AMH 0.8, LH 7.4. The doctor said everything looks fine or mentioned you might want to move quickly. You came home with a paper and no real understanding of what any of it means. Let me give you that understanding.
FSH: What It Tells You About Your Ovaries
FSH, follicle-stimulating hormone, is produced by the pituitary gland to signal your ovaries to develop follicles. When ovarian reserve is declining, the pituitary compensates by producing more FSH. So an elevated FSH generally reflects that the ovaries are having to work harder.
However, FSH fluctuates significantly based on your estradiol level. When estradiol is low early in your cycle, FSH will be falsely elevated. When estradiol is too high, FSH will be falsely suppressed. This is why you cannot interpret FSH without the corresponding estradiol value. IVF clinics typically prefer FSH below 15, but FSH levels have no correlation to egg quality.
Take the Fertility Hormones 101 Masterclass here.
AMH: Quantity, Not the Full Story
AMH does not measure your total egg reserve. There is no blood test that can measure that. AMH is produced only by the follicles actively developing that month, which means it is a snapshot of current output, not a fixed number. It moves with stress, inflammation, nutrition, and sleep because the cells producing it are highly sensitive to the environment they are living in right now.
Think of it like a factory floor. AMH tells you how many workers showed up this month. It does not tell you how many are still in the hiring pool. If the floor is on fire, fewer workers show up and the ones who do underperform. That does not mean the factory is closed.
In my clinical experience, and increasingly in the research, a low AMH is often less about age and more about what is happening in the ovarian environment itself. Chronic inflammation, undiagnosed autoimmunity, endometriosis, thyroid antibodies, gut dysfunction, even the story you have been told about your own numbers, all of it can be reaching the ovaries and driving that number down. When that environment shifts, the number can shift too, sometimes significantly.
I break down the full mechanism, the research, and a real patient case where AMH rose 71 percent after we addressed what was actually driving it, in my two part series on Substack. If you have been handed a diagnosis based on this number, that is where to go next.
Download the Fertility Labs Guide here to see exactly which numbers to request and what ranges actually matter.
LH: The Ovulation Trigger
LH triggers the release of the mature egg from the follicle. Premature surges, absent surges, or an elevated resting LH relative to FSH can all signal disruption. An LH to FSH ratio above 2:1 or 3:1 on cycle day 2 or 3 suggests possible PCOS.
These numbers are tools. They are not sentences. They are information you can act on.
Learn more about One-on-One Fertility Coaching here.
Get the full breakdown in the revised edition of Yes, You Can Get Pregnant.
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This post is for educational purposes only and is not a substitute for personalized medical advice. Please consult your own doctor before making changes to your care.