Female-Fertility Assessment: AMH and FSH Testing Complete Guide
For women planning pregnancy,
understanding ovarian reserve—the quantity and quality of remaining
eggs—is critical. With 1 in 8 couples facing infertility 11, proactive testing can provide
clarity for family planning. Two key hormones help assess fertility potential:
· Anti-Müllerian
Hormone (AMH): Reflects
egg quantity.
· Follicle-Stimulating
Hormone (FSH): Indicates
pituitary-ovarian communication.
By age 30, women lose ~90%
of their eggs 11,
and by 40, fertility declines sharply. Testing AMH and FSH offers insights into
reproductive health, but it’s just one piece of the puzzle.
AMH Test: Measuring Ovarian
Reserve
What AMH Measures
AMH is produced by small ovarian
follicles. Higher levels suggest a robust egg supply, while low levels
indicate diminished ovarian reserve (DOR) 48.
How It Works
· Blood
test measuring
AMH levels (no cycle-day restrictions) 7.
· Stable
hormone:
Less fluctuation than FSH 8.
Normal AMH Ranges by Age 5
|
Age
Group |
AMH
Level (ng/mL) |
|
20–29 |
3.0–5.0 |
|
30–34 |
2.0–4.0 |
|
35–39 |
1.0–3.0 |
|
40+ |
<1.0 |
Interpreting Results
· Low
AMH (<1.0 ng/mL): Fewer
eggs remaining; may suggest early menopause risk 8.
· High
AMH (>4.0 ng/mL): Possible PCOS (excess
follicles) 4.
Pros and Cons
✅ Pros:
· Predicts
IVF response (higher AMH = more eggs retrieved) 12.
· Can
be tested any cycle day.
❌ Cons:
· Doesn’t
assess egg quality or guarantee pregnancy 5.
· Levels
vary slightly between labs 8.
FSH Test: Evaluating Ovarian
Function
What FSH Measures
FSH, produced by the pituitary
gland, stimulates follicle growth. High FSH suggests the ovaries are struggling
to respond, signaling declining reserve 210.
When to Test
· Day
3 of menstrual cycle (most
accurate) 7.
Normal FSH Levels 610
· Optimal: <10 mIU/mL
· Concerning: >12 mIU/mL (indicates
perimenopause or DOR).
Limitations
· Monthly
fluctuations:
Stress or illness can skew results 10.
· False
negatives:
Estrogen spikes may mask high FSH 12.
AMH vs. FSH: Key Differences
|
Factor |
AMH
Test |
FSH
Test |
|
Measures |
Egg quantity |
Pituitary-ovarian
communication |
|
Best For |
Long-term
reserve assessment |
Monthly cycle
evaluation |
|
Timing |
Anytime in
cycle |
Day 3 of
period |
|
Stability |
More
consistent |
Varies
monthly |
Expert Insight:
"AMH is the best marker for ovarian reserve, but FSH helps confirm
ovarian function. Together, they provide a fuller picture." — Dr.
Kenosha Gleaton, OBGYN 5.
Who Should Get Tested?
Testing is recommended for:
· Women >35 planning
pregnancy 11.
·
Those with:
o Irregular
periods
o Family
history of early menopause
o Prior
ovarian surgery/chemotherapy 7.
Interpreting Results & Next
Steps
Low AMH/High FSH
·
Consult a fertility specialist for options like:
o Egg
freezing (if
AMH is borderline).
o IVF
with donor eggs (if
reserve is very low) 11.
Normal AMH/FSH But Not
Conceiving?
·
Check for:
o Blocked
fallopian tubes (HSG
test).
o Sperm
health (male
factor infertility) 6.
Other Fertility Tests to Consider
1. Antral
Follicle Count (AFC): Ultrasound
to count egg-containing follicles 7.
2. Estradiol
(E2): Paired
with FSH to rule out false lows 12.
3. Thyroid/PRL
Tests: Imbalances
can disrupt ovulation 11.
Latest Advances
· At-Home
AMH Tests: Brands
like Everlywell offer convenience 5.
· Genetic
Testing: Screens
for Fragile X (linked to early menopause) 11.
Conclusion & Actionable Steps
· AMH = Egg quantity; FSH =
Ovarian response.
· Test
early if
delaying pregnancy (ideal: late 20s/early 30s).
·
Next Step: Schedule a consultation if:
o AMH
<1.0 ng/mL or FSH >12 mIU/mL.
o You’ve
been trying to conceive for 6+ months (if >35) 11.
FAQ Section
Q: Can AMH predict menopause
timing?
A: Roughly—low AMH may signal
menopause ~5 years earlier, but genetics play a role 8.
Q: Does low AMH mean I can’t
conceive naturally?
A: No, but it may reduce
chances. Egg quality matters more 5.
Q: Can lifestyle changes improve
FSH?
A: Limited evidence, but stress
reduction and balanced nutrition may help
