Ovarian Reserve Testing

With increasing age, a woman’s fertility starts declining. As they get older, the number, as well as the quality of their eggs, also declines. Not only this, the eggs tend to have more chromosomal abnormalities than usual. Due to this, older women have a lower pregnancy rate and a higher rate of miscarriage.

There is no fixed age when a woman can no longer conceive. However, in some cases, this may occur at a younger age than expected. Many women face problems getting pregnant after the age of 35 years. Several tests are available to check the fertility potential of a woman, also called an ovarian reserve.

About Ovarian Reserve Testing

Ovarian reserve, commonly referred to as the egg count, is typically measured using a variety of tests including Anti-Mullerian hormone (AMH), antral follicle count, and blood tests. The most common method of determining one’s ovarian reserve is with the help of blood tests including estradiol, inhibit, and FSH.

AMH refers to a protein hormone produced in the ovarian follicle cells. The level of a woman’s AMH is used to estimate the number of follicles in the ovaries. Antral follicle count, on the other hand, is checked using an ultrasound. In this procedure, the radiologist visualizes the ovaries and counts the ‘activated’ follicles. This number is then used for the estimation of total ovarian reserve.

Preparing for Ovarian Reserve Testing

One does not need to make any special preparations for ovarian reserve testing. Estradiol, antral follicle count, and FSH tests are usually done between the second and fifth day of the patient’s menstrual cycle. AMH test, on the other hand, can be done on any day of the cycle.

What to expect during Ovarian Reserve Testing?

Ovarian reserving testing is a simple blood test that feels the same as any other blood test. The blood sample is taken preferably on day 3 of a woman’s menstrual cycle. However, samples taken on day 2 and day 4 are also acceptable. Besides this, your doctor may also decide to do an ultrasound test to check the egg count.

Possible Results of Ovarian Reserve Testing

The doctors, to predict the body’s response to fertility treatments, use ovarian reserve tests. The results help them determine how likely it is that the patient will get pregnant. Abnormal results for these tests suggest the debility of fertility potential. However, they cannot completely predict whether one will conceive or not. Some younger women who get normal test results also face problems getting pregnant. The results may also differ with each cycle.

The possibility of the patient getting pregnant primarily depends on the quality of her eggs. Women older than 35 years of age with abnormal results in the tests have a much lower chance of getting pregnant. In such cases, the patient can choose to go for donor eggs.

Antral follicle count and AMH testing can also be used to check for potential reproductive issues such as PCOS (polycystic ovarian syndrome). Women with high ovarian reserves are more likely to respond positively to hormone medications that are commonly administered for fertility treatments.

When should you see your doctor?

If you are planning to test your ovarian reserve, you must consult your doctor:

  • Before undergoing any tests or treatment for your infertility
  • When planning ART ovarian stimulation and dosing
  • Familial history of premature ovarian failure or early menopause
  • For fertility preservation before gonadotoxic treatment
  • In the case of Polycystic ovarian syndrome (PCOS)
  • If going through Perimenopause
  • Preparing for ovarian surgery
  • Detection of FMR1 or BRCA-1 premutation


Ovarian reserve testing is a great way to get valuable insight into a woman’s fertility. In most cases, doctors recommend egg count testing for women over the age of 35 years who have not yet gotten pregnant. It is also commonly recommended for women with PCOS and people planning to undergo egg freezing and IVF. Common tests such as AFC, AMH, and estradiol are used for this. If you believe you need ovarian reserve testing, get in touch with us for appropriate guidance.

Request an appointment at

Apollo Fertility, Banjara Hills, Hyderabad

Call 1860 500 4424 to book an appointment

1. What is a good result in ovarian reserve testing?

Numbers between 0.7 and 5 are considered normal when it comes to ovarian reserve testing. Levels below 0.7 show that the ovarian reserve is depleting.

2. Can I have a healthy baby even with a low ovarian reserve?

A low ovarian reserve may sound scary, but it does not mean that you are completely infertile. If you are under 35 years of age and ovulating regularly, you still have the same chances of getting pregnant as someone with normal results in ovarian reserve testing.

3. Is ovarian reserve testing painful?

Some women consider vaginal ultrasound uncomfortable. However, it is usually not painful.

4. What are the signs of a low ovarian reserve?

Common symptoms that may suggest a diminishing ovarian reserve include problems getting pregnant, heavy menstrual flow, absent or late periods, shorter menstrual cycles, and recurrent miscarriage.

5. What is the most popular test used for ovarian reserve testing?

The most commonly used tests for ovarian reserve testing include anti-Mullerian hormone, basal follicle-stimulating hormone and antral follicle count.

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