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Ovarian Reserve Testing: A Guide to Fertility Assessment

We will explore ovarian reserve testing, including its importance, available tests, how they work, and where to get them.


When it comes to fertility and family planning, understanding your ovarian reserve is a crucial. Ovarian reserve refers to the number of eggs (oocytes) remaining in the ovaries and is used to predict the results of ovarian stimulation for egg freezing or IVF. Ovarian reserve testing is very often one of the first steps in starting fertility treatment: fertility assessment. 

It is important to understand that while it helps to better forecast the number of eggs retrieved during IVF or egg freezing cycle, it doesn't assess your reproductive potential and quality of your eggs.

What is Ovarian Reserve Testing?

Usually, ovarian reserve testing is based on biochemical analysis (blood test) and ultrasound. The most common blood test includes measuring the following hormones: FSH, AMH, and estradiol. 

AMH (anti-mulleran hormone): is produced by small ovarian follicles and as the number of follicles declines over time, AMH serves as a simple and direct measure of the number of remaining eggs. AMH levels can be tested at any time during the cycle. Higher AMH may mean that you would need a lower dosage of hormones during fertility treatment and better harvesting of eggs with the procedure.

FSH (Follicle-Stimulating Hormone): The hormone that helps stimulate the growth of the eggs in ovaries and is produced by a pea-sized body attached to your brain - the pituitary gland. FSH levels vary throughout your cycle and are highest in the beginning (that's when it's usually checked, but it also depends on your doctor's preference). 

Estradiol is usually measured on the same day as FSH and can help with additional interpretation of FSH (whether FSH is accurate or not).

AFC (Antral Follicle count)

This test uses transvaginal ultrasound to count the number of follicles in the ovaries, which can give an estimate of ovarian reserve. 

Why is Ovarian Reserve Testing Important?

Ovarian reserve testing should be used in the context of your age and together with other diagnoses. It helps to set expectations and choose between different treatment options.

Where to Get Ovarian Reserve Testing

If you're considering fertility assessment for egg freezing or IVF, you can start by consulting with a reproductive endocrinologist or a fertility specialist. They can recommend the most appropriate tests for your situation and guide you through the process. You can find fertility clinics and specialists near you throughout our database of all fertility clinics in the US.

Even though there are a number of commercial at-home fertility tests that are used to measure AMH, they vary a lot in accuracy and methodology. That’s why it is recommended to do ovarian reserve testing at the fertility clinic, where a properly trained fertility specialist will analyze it together with other parameters, such as age and diagnosis.

Cost of Ovarian Reserve Testing

The cost of ovarian reserve testing can vary widely depending on the type of test, your location, and whether you have insurance coverage. It is often covered by insurance, and It's essential to check with your healthcare provider or fertility clinic to understand the costs involved.


Ovarian reserve testing is a common procedure performed during initial fertility evaluation. It helps to guide your treatment, estimate your response to ovarian stimulation for IVF and egg freezing, and select between different treatment options. For egg freezing, it helps to build expectations on the results of the egg retrieval and plan your treatment according to your family goals and budget. If you are ready to start your fertility assessment, book a consultation with a fertility clinic near you.

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