IVF guide
AMH and ovarian reserve
Ovarian reserve describes the number of eggs remaining in the ovaries. Tests such as AMH and the antral follicle count help physicians plan treatment.
What AMH is
Anti-Müllerian hormone (AMH) is made by small follicles in the ovaries. Its level in the blood gives an idea of how many small follicles there are. AMH levels usually decrease with age.1
Other ovarian reserve tests
- Antral follicle count (AFC): the small follicles in both ovaries are counted with a vaginal ultrasound, usually early in the cycle.
- FSH and estradiol: blood tests usually taken on day 2 to 4 of the cycle.1
How the results are used
Ovarian reserve tests help the physician choose the medication dose and protocol for stimulation, and estimate how many eggs may be collected. A high AMH may suggest a stronger response and a higher risk of OHSS. A low AMH may suggest that fewer eggs will be collected.2
What the tests cannot show
- They do not measure egg quality.
- They cannot on their own predict whether a pregnancy will occur.1
- A low result does not mean that natural pregnancy is impossible.
Age and fertility
Female fertility gradually decreases with age, and the decrease becomes more marked after the mid-thirties. Age affects both the number and the quality of eggs. For this reason, the physician evaluates age together with the test results.3
At a glance
- AMH is a blood test that can usually be done on any day of the cycle.
- The antral follicle count is measured by ultrasound.
- These tests estimate egg number, not egg quality.
- Results are interpreted together with age and history.
Frequently asked questions
Fasting is not usually required. The laboratory or physician gives the instructions.
There is no proven method to increase ovarian reserve. Claims about supplements should be discussed with the physician.
Not necessarily. A high AMH can be seen in polycystic ovary syndrome and may increase the risk of OHSS during stimulation.4
References
- Practice Committee of the American Society for Reproductive Medicine. Testing and interpreting measures of ovarian reserve: a committee opinion. Fertility and Sterility. 2020;114(6):1151–1157.
- ESHRE Guideline Group on Ovarian Stimulation, Ata B, et al. ESHRE guideline: ovarian stimulation for IVF/ICSI: an update in 2025. Human Reproduction. 2026;41(4):498–514.
- American College of Obstetricians and Gynecologists. Female age-related fertility decline. Committee Opinion No. 589. Obstetrics & Gynecology. 2014;123(3):719–721.
- Teede HJ, Tay CT, Laven JJE, et al. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Journal of Clinical Endocrinology & Metabolism. 2023;108(10):2447–2469.
Related topics
This page gives general information only. It does not replace an examination, and the treatment plan is decided by the physician for each person individually.