Why Should You Check Your Egg Reserve?

11 Jan 2023

11 Jan 2023

by Dr. Oybek Rustamov in Fertl Edu

Why should I bother?

You may or may not be ready to have kids now. But, you are probably wondering if you can have kids once you are ready. You must be thinking, Is there a way I can tell if I can have kids? What if I can’t get pregnant? What problems might I have when I try? Am I going to be too old by then? Will I be able to produce eggs?

This is natural. It is natural to wonder about your future.

We all know there is no such thing as a crystal ball. We know we cannot say with certainty if we can have kids. Since there are so many factors involved in starting a family, it is not possible to tell if or when you can have kids.

However, having a sufficient number of eggs is the most essential factor in female fertility. Yes, other problems such as blocked tubes, not ovulating, or issues with your partner’s sperm can stop you from getting pregnant. But most of these problems can be overcome with the right fertility treatment. But if you do not have any eggs left in your ovaries, then you can’t have a biological child.

Hence, monitoring your current ovarian reserve is essential to planning your future fertility. This is the reason it is recommended for all women planning to have kids in the future to check their egg reserve. A simple blood sample for the Anti-Müllerian hormone (AMH) can tell you the number of eggs you have in your ovaries. Using the chart of your AMH levels, you can predict the number of eggs you are going to have in each year of your life until you hit menopause.

Your AMH test result is a vital sign of your fertility.

With that, your AMH Chart shows the future direction of your fertility. Knowing your AMH Chart can help you find out your reproductive options sooner and plan your future fertility strategies.

What is an egg reserve, anyway?

Women are born with all the eggs they will ever have. During their lifetime they can not create new eggs. They can only store inactive, or “sleeping” eggs in their ovaries.

All women are not born with the same amount of eggs in their ovaries. Some women are born with a very high number of eggs. For example, women with polycystic ovary syndrome (PCOS) have a very high ovarian reserve. Hence, they lose their reserve slowly and retain their ovarian fertility longer. Women with PCOS have late menopause, as they keep their ovarian function longer than other women.

On the other hand, women with premature ovarian insufficiency (POI) have a low ovarian reserve and run out of the remaining eggs faster and experience early menopause.

Your egg reserve is the most defining part of your fertility.

It determines how long you stay fertile. It is like your fertility fuel tank. The fuller it is, the longer you can go. Your AMH levels are the indicator arrow of your ovarian reserve. The higher your AMH test result, the higher your egg reserve and the longer your fertility.

Once you know how long you are going to stay fertile, you can get the right advice at the right time.

What about my age, though?

Your age is an important indicator of your fertility as it determines the quantity and quality of the eggs in your ovaries. As you get older you keep losing the reserve of eggs gradually. With age, your egg reserve only goes one way, which is unfortunately down.

This means that whether your egg reserve is low, average, or high at the starting point, you keep losing eggs in your ovaries as you age.

Additionally, the egg quality in your ovaries is affected by age. This does not mean all eggs in ovaries become of poor quality. It simply means that the proportion of high-quality eggs will decline with age. For instance, at the age of 30, 70 percent of released eggs are normal. In contrast, at the age of 40, the quality of 30 percent of eggs is normal.

So, you can use the AMH test to know the quantity of your eggs and age to tell the quality of your eggs. If you put them together, you can have a fairly good idea of how your fertility is going to behave in the future.

For example, if you have high Anti-Müllerian hormone levels, you can still produce high-quality eggs. Simply because you have so many eggs in your ovaries, even 30 percent of them can give you the family you want.

In contrast, if you have low AMH and are running out of egg reserve, even at a young age, you may have problems with getting pregnant. Therefore, you may want to expedite the fertility plans or take necessary precautions.

What is AMH?

AMH stands for Anti-Müllerian Hormone, which is produced from growing egg sacs.

Since AMH is produced from growing egg sacs, the level of AMH in the blood reflects the number of follicles in the ovaries. Similarly, the number of growing follicles reflects the number of resting, inactive follicles in a woman’s ovaries.

These resting follicles are called primordial follicles, the amount of which determines the size of the ovarian reserve.

Consequently, the larger the amount of primordial follicles or ovarian reserve, the higher the number of growing follicles and the higher the level of AMH. The exact opposite is also true. If the ovarian reserve is low, the lower the number of growing follicles and the lower the level of AMH.

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Relationship Between AMH and AFC

These growing follicles that produce AMH are called pre-antral follicles and antral follicles. The antral follicles, measuring between 2 mm and 10 mm, are visible on an ultrasound scan and can be counted. The total number of antral follicles in both ovaries is called the antral follicle count, or AFC, in short. Since AMH is produced from antral follicles, the levels of these markers correlate. So, the higher the AFC, the higher the AMH test result.

Overall, high and normal levels of AMH and AFC are indicators of a high and normal ovarian reserve. This is a very reassuring sign of female fertility. Since eggs are the most fundamental units of female fertility, having a high or normal amount of eggs indicates good reproductive health.

The AMH test and AFC are currently used for diagnosing the causes of infertility and deciding which treatment should be used in women who already have infertility. So, currently, the AMH test and AFC are used for the diagnosis and treatment of infertility.

We argue that, in addition to its current use, the AMH test should be used for fertility screening purposes. AMH testing can establish the current level of the ovarian reserve in each woman. This allows the doctors to predict their future ovarian reserve. Hence, women can predict their future ovarian fertility and make family-building plans accordingly.

For instance, if three 30-year-old friends named Anna, Beth, and Claire do their AMH tests, they will most likely get the following result:

Anna: Low AMH

She needs to either start trying to conceive early if she is ready to start a family or consider freezing her eggs.

Beth: Normal AMH

She can start making family building plans and monitor her Anti-Müllerian hormone levels every year. If she is still not ready to have kids and her AMH is going low, she may need to consider egg freezing.

Claire: High AMH

She can relax because her fertility age is younger than her chronological age. She can decide to start conceiving when she is ready. If she is delaying this decision, she can repeat her AMH test after 2 to 3 years.

With these examples, before the AMH test, the three friends had a similar idea about their fertility. After the AMH test, they now have clear ideas about their egg reserves and can make the right fertility plans for themselves.


In summary, each woman is born with a certain number of eggs in her ovaries, and she cannot create any more eggs during her lifetime. All women do not have the same amount of eggs in their ovaries. Women with a low number of eggs in their ovaries are at risk of losing their ovarian reserve earlier. The AMH blood test can tell each person’s ovarian reserve. This allows women with poor egg reserves to complete their families earlier or freeze their eggs for future use.


1Ectopic pregnancy. (2017).
2Mayo Clinic Staff. (2015). Ectopic pregnancy.
3Perkins KM, et al. (2015). Risk of ectopic pregnancy associated with assisted reproductive technology in the United States, 2001-2011.

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