Ovarian Reserve Testing: Why AMH and AFC Are the Roadmaps to Your Fertility Future
Introduction | Knowledge Is Power — Even If You’re Not Planning Pregnancy Yet
You may be at a stage in life where your focus is on education, career growth, or personal development. Perhaps you haven’t found the right partner yet, or you’ve consciously decided to postpone parenthood for a few more years. In all of these situations, one biological reality remains constant and cannot be ignored: female fertility is time-limited.
Many women believe that as long as their menstrual cycles are regular, their fertility is guaranteed. However, in reproductive medicine, regular menstruation does not necessarily mean a healthy ovarian reserve or secured fertility in the future.
This is where two essential indicators—AMH and AFC—become crucial.
These tests are not only for women undergoing infertility treatment; they are powerful tools for predicting future fertility, making informed decisions, and preserving reproductive choices.
What Do AMH and AFC Actually Measure?
To assess ovarian reserve, clinicians rely on a combination of a blood test and a specialized ultrasound. Each provides a different but complementary part of the fertility picture.
Anti-Müllerian Hormone (AMH) | The “Inventory Marker”
AMH is produced by very small growing follicles in the ovaries. Unlike many reproductive hormones, AMH levels remain relatively stable throughout the menstrual cycle and can be measured on any day.
What AMH tells us:
- An estimate of the remaining egg quantity in the ovaries
What AMH does not tell us:
- The genetic quality or developmental potential of those eggs
In simple terms, AMH reflects quantity—not quality.
Antral Follicle Count (AFC) | A Direct Look at Ovarian Activity
AFC is measured via transvaginal ultrasound during the early days of the menstrual cycle. The physician counts small follicles (usually 2–10 mm in size) within the ovaries.
This marker:
- Correlates strongly with ovarian response to stimulation medications
- Plays a key role in selecting treatment protocols for IVF or egg freezing
Why Should Young and Single Women Care About These Numbers?
A common misconception is that ovarian reserve testing is only useful for married women or those actively trying to conceive. In reality, evaluating AMH and AFC at a younger age—late 20s or early 30s—can significantly impact life planning.
Early Detection of Ovarian Reserve Decline
Some women experience a premature decline in ovarian reserve due to genetic or unexplained reasons (Primary Ovarian Insufficiency). Identifying this early allows time-sensitive options such as social egg freezing.
Informed Future Planning
Knowing your ovarian reserve enables you to:
- Postpone pregnancy with greater peace of mind if reserve is adequate
- Reconsider life priorities if reserve falls within a warning range
Knowing your ovarian reserve is not about fear—it’s about taking control of your reproductive future.
Quantity vs. Quality | The Missing Link: Egg Morphology
A frequently asked question is:
“If my AMH is high, does that mean my eggs are high-quality?”
The honest scientific answer is: Not necessarily.
- AMH and AFC measure quantity
- Age is the strongest predictor of egg quality
As age increases, the likelihood of genetic and structural abnormalities in eggs also rises—even if egg numbers remain sufficient.
Egg morphology (shape and structure) can only be assessed once eggs are retrieved during IVF. Research shows that aging eggs are more likely to have:
- Cytoplasmic abnormalities
- Harder or thicker zona pellucida
- Chromosomal errors (aneuploidy), leading to implantation failure or miscarriage
This explains why:
- A 38-year-old woman may have normal AMH but fewer viable eggs
- A 28-year-old woman with low AMH may still conceive due to excellent egg quality
How Do AMH and AFC Guide Treatment Decisions?
For women undergoing IVF or egg freezing, these markers act as a clinical compass.
Personalized Treatment
Based on AFC, physicians determine:
- Medication type
- Dosage levels
The goal is to retrieve the maximum number of healthy eggs while minimizing physical stress.
Realistic Expectation Management
When ovarian reserve is low:
- Multiple retrieval cycles may be required
- Awareness from the start reduces emotional stress and disappointment
Conclusion | What Is Your Next Step?
Your body constantly sends signals—but understanding them requires scientific tools.
AMH and AFC translate the language of your ovaries.
Whether you are single, planning pregnancy, or considering fertility preservation, knowing these numbers allows you to make informed, proactive decisions rather than relying on chance.
Through the DLady app, we support you in:
Managing your fertility future with clarity and confidence
Tracking your menstrual cycle intelligently
Accessing reliable, up-to-date reproductive health content
