When you have been trying to conceive for a while without any luck, it can be difficult to know what your next steps should be. Should you make an appointment with your OBGYN? What about scheduling a consultation with a fertility specialist? If those options sound too daunting or out of reach for you right now, there is another, simpler option. 

No laboratory test is a crystal ball into the likelihood of a future pregnancy, but an ovarian reserve test is a simple blood test that can be an effective way of measuring the hormones that play a vital role in reproduction. It can also help you figure out if there are any underlying conditions that could be impeding your ability to conceive naturally. 

An ovarian reserve test can even help assess egg quantity to predict ovarian response to stimulation if you were to ever go the route of in-vitro fertilization (IVF). Overall, it is a good first step that can help you discuss your options with your doctor and make more informed decisions on your fertility journey.

What does ovarian reserve testing look for?

1. AMH

AMH, or Anti-Müllerian Hormone, is produced by the follicles in a woman’s ovaries. Therefore, AMH is often used as a marker of the number of eggs remaining in a woman’s ovarian reserve.

An adequate level of AMH is considered greater or equal to 1 ng/mL, but less than 6 ng/mL. Less than 1 ng/mL may indicate that a woman has a lower, or diminished, ovarian reserve. 

However, it’s important to note that AMH does not predict the ability to naturally conceive. It is possible to get pregnant with your own eggs with low AMH, and normal levels of AMH do not always equate to an easy road to pregnancy. 

While it won’t give you the full picture of your reproductive potential, AMH can be a great indicator for your OBGYN or fertility doctor to assess your reproductive status and whether or not you would be a good candidate for fertility treatments like Intrauterine Insemination (IUI) or In Vitro Fertilization (IVF) down the road. 

2. FSH

Follicle-stimulating hormone (FSH) is made by your pituitary gland, which is located at the base of the brain. In women, FSH helps control the menstrual cycle and stimulates the development of eggs in the ovaries. FSH is also the same hormone that is contained in the injectable gonadotropins which are used to produce multiple eggs for infertility treatment.

FSH levels in women change throughout the menstrual cycle, with the highest levels before ovulation. As women age, FSH levels increase in response to a drop in estradiol hormone production due to the negative feedback loop mechanism. Since FSH is one of the critical hormones responsible for follicle development, if the ovaries are losing follicles due to aging, or surgery, FSH levels will rise. 

‘Normal’ FSH is considered to be anything under 9 mIU/ml, while even mildly elevated levels such as 10-15 mIU can be an indication of a drop in estradiol hormone essential for uterine health and placenta development during pregnancy. When tested on or around day 3 of your menstrual cycle, FSH can serve as a good benchmark for your OBGYN or fertility doctor as to whether or not you have ‘normal’ reproductive hormone levels.

3. Estradiol

Estradiol is a type of estrogen hormone that is secreted by the ovaries. As the follicles grow and develop each month, they produce estradiol and set the rest of the reproductive cycle in motion. 

One reason to have your estradiol levels checked is to determine your ovaries’ ability to produce eggs. High levels of estradiol on or around day 3 of your cycle can indicate that there is a problem with your ovarian reserve. However, it can also help to determine if your FSH test was accurate or not. Estradiol suppresses FSH, so if your FSH levels are normal but your estradiol levels are high, this can indicate that the estradiol is artificially suppressing your FSH levels.  

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Elevated estradiol levels can indicate polycystic ovary syndrome (PCOS). Either of these things could mean that you will have more trouble getting pregnant. If you have already begun fertility treatment, your doctor might also check your estradiol levels to see how your ovaries are responding to stimulation. 

Estradiol can tell you a lot about what is going on in your body at various times throughout your cycle, which is why it is one of the most common fertility tests. 

What can ovarian reserve testing tell us? 

By using an easily accessible blood test to track your levels of AMH, FSH, and Estradiol, ovarian reserve testing can be a great first step to help indicate how likely you are to get pregnant compared to other women of the same age. Knowledge is power when it comes to your reproductive health, and ovarian reserve testing can help give you and your doctor the answers you need to make well-informed decisions about your future fertility. And that’s pretty cool. 

You can learn more with Labcorp OnDemand’s Women’s Fertility Package (Ovarian Reserve) Test. It’s the same lab test trusted by doctors and can easily be purchased with a credit card or using HSA/FSA. The results will be sent directly to you and if you desire, can be shared with your healthcare team. 

In addition to Labcorp OnDemand’s Women’s Fertility Package, you can purchase other health and wellness tests, including the Women’s Health Blood Test, Pregnancy Blood Test, Thyroid Stimulating Hormone, and more.

Kristyn Hodgdon is the Co-Founder and Chief Creative Officer at Rescripted.