What does a low level of antimüllerian hormone mean?

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What happens if I have a low anti-müllerian hormone?

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AMH or Anti-Mullerian Hormone, There are two ways to discuss a low AMH level in a woman:

She has a low AMH level for her age: this simply means that it is lower than the average for women of her age; it is a statistical average with little significance, as the range between values considered high and low is wide.
She has a low AMH level in general: there is no consensus on the level at which it is considered low: for some teams, a low level starts at 1.5 ng/ml, for others at 1 or 0.75 ng/ml... Each team has its own standards and practices.

First, what precautions should be taken in interpreting this result:

Which test? There have been many technical issues with manual testing methods of the first and second generation. The only currently reliable tests are the automated tests of the third generation: this is something to verify.
What context? Some situations naturally result in an artificially low AMH level, as follicular development is inhibited: under birth control pills, under analogues of GnRH, in case of hypogonadism... Some conditions can damage the follicular stock: chemotherapy and endometriosis in particular. Finally, the AMH level should be interpreted with great caution before the age of 25.

In the context of couple infertility, the estimation of ovarian reserve has only one purpose: to predict the ovarian response to controlled hyperstimulation for in vitro fertilization (IVF); the higher the AMH level, the greater the quantity of collected oocytes, the more embryos obtained, and therefore the higher the chances of having at least one good quality embryo and a pregnancy.

On the other hand, the AMH level has no particular value in a classic infertility journey, "natural" or with insemination: pregnancies are possible with AMH levels below 0.5 ng/ml.

However, it provides an important element in the therapeutic strategy: a relatively low level may lead to a quicker decision for IVF, for fear of reaching IVF with a low enough level to risk being rejected.