What fertility tests can and can't tell you
What they are
Three tests are used to estimate ovarian reserve, how many eggs are left:1
- AMH (anti-Müllerian hormone), a blood test that can be done on any day of the cycle.
- Antral follicle count (AFC), a transvaginal ultrasound that counts small follicles in the ovaries.
- FSH and estradiol, blood tests done early in the cycle, usually on day 3.
What they can tell you
These tests are useful for planning fertility treatment. They help predict how someone's ovaries will respond to the medicines used in IVF and egg freezing, and how their egg supply compares with others their age.1,2
What they can't tell you
Myth: An AMH test tells you how fertile you are.
tests are often promoted this way, so it's easy to see why people believe it.3 In a 2017 study of women aged 30 to 44 trying to get pregnant naturally, those with low were no less likely to conceive within a year: 84% compared with 75% for those with normal AMH, a difference that wasn't meaningful.3 The researchers cautioned against using AMH to judge current fertility.3
- They don't measure egg quality, which matters most for getting pregnant.1,4
- No single test can predict whether someone will get pregnant. A low result doesn't mean someone can't, and a normal result doesn't mean they will.1
- Results vary from cycle to cycle and lab to lab.1
ACOG says using AMH for fertility counseling in women who haven't been diagnosed with infertility isn't supported by high-quality data.2 Still, for someone planning to delay pregnancy, it can be a useful if imperfect starting point for a conversation with a specialist.4
Both partners
A fertility checkup looks at both partners. For men, it starts with a medical history and a semen analysis, which counts sperm and checks how they move.5 The fertility for men lesson covers this.
Questions to ask
- What will this test tell me, and what won't it?
- How would the result change what I do?
- Should my partner be tested too?
Recap
- AMH, antral follicle count and FSH estimate how many eggs are left.
- They help plan fertility treatment, such as predicting the response to IVF medicines.
- In a large study, women with low AMH were no less likely to get pregnant naturally within a year.
- No single test can predict whether someone will get pregnant. Egg quality can't be tested.
- A fertility checkup includes both partners. For men, it starts with a semen analysis.
Words to know 5
| AMH (anti-Müllerian hormone) | A hormone made by growing follicles. Its blood level reflects how many eggs are left. |
|---|---|
| antral follicle count (AFC) | A count of small follicles in the ovaries on a transvaginal ultrasound. |
| FSH (follicle-stimulating hormone) | A hormone from the pituitary gland that makes follicles grow. It's tested early in the cycle. |
| ovarian reserve | The number of eggs left in the ovaries. |
| semen analysis | A lab test of a semen sample that measures sperm count, movement and shape. |
Educational information, not medical advice. Talk to your doctor about your health.