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Mr Parijat Bhattacharjee, Private Consultant Gynaecologist, Harrow, Brentford, Northwood, London, UK / Media / Videos » Ovarian Reserve Tests

Ovarian Reserve Tests

Ovarian Reserve Tests
Posted on: 03-Jul-2026

This video, titled "Ovarian Reserve Tests" by Gynae Consultant, outlines the purpose, types, and interpretations of clinical tests used to assess a woman's remaining egg supply, emphasizing their true utility in medical treatments versus natural conception.

The Purpose of Ovarian Reserve Tests

  • The IVF Connection: Ovarian reserve tests were explicitly developed to predict how a woman's ovaries and follicles (the fluid-filled sacs containing eggs) will respond to fertility medications during assisted reproduction or an IVF cycle.
  • A Common Misconception: These tests were not designed to assess natural fertility. A low score does not automatically mean a woman cannot get pregnant naturally, and results regarding natural fertility should always be interpreted with caution.

Three Main Ovarian Reserve Tests

The primary tests used in clinical practice consist of two blood tests (hormone panels) and one pelvic ultrasound:

1. FSH (Follicle-Stimulating Hormone)

  • What it is: Produced by the pituitary gland in the brain, FSH travels through the bloodstream to stimulate follicle development in the ovaries.
  • Testing Windows: Because FSH levels fluctuate throughout the menstrual cycle, blood must be drawn during the early basal phase—ideally between day 2 and day 5 of the cycle.
  • Interpretation: A normal standard baseline falls between 2 and 8.9 IU/L, which is the amount of hormone required to mature a single follicle normally. A high FSH level serves as an indirect indicator of a low ovarian reserve and an anticipated poor response to IVF drugs.

2. AMH (Anti-Müllerian Hormone)

  • What it is: AMH is directly produced by the growing follicles themselves, making it a more direct and reliable measure of ovarian reserve than FSH.
  • Testing Windows: Unlike FSH, AMH levels do not fluctuate significantly across different phases of the menstrual cycle, meaning the blood test can be performed at any time.
  • Interpretation: Levels generally range between 3 and 35 pmol/L. A low AMH reflects a depleted ovarian reserve (fewer eggs available for extraction during IVF), while a very high AMH is often a clinical marker for Polycystic Ovary Syndrome (PCOS).

3. AFC (Antral Follicle Count)

  • What it is: A direct visual assessment performed via an internal (transvaginal) ultrasound scan.
  • Methodology: A specialist physically counts the number of small, active follicles visible in the ovaries during the early phase of the menstrual cycle to estimate potential egg yield.

The Most Critical Factor: Age

While hormone panels and ultrasound counts provide valuable benchmarks for fertility treatments, a woman's age is the single most important determinant of both egg quantity and egg quality.

  • Declining Quality: As age advances, the cellular quality and overall number of viable eggs decrease drastically.
  • Age vs. Reserve Scores: Age often overrides reserve test metrics during clinical treatments. For example, a younger woman with a low ovarian reserve score is still statistically more likely to succeed in IVF than a woman over the age of 40 who happens to have a high ovarian reserve score.