Ovarian Reserve Testing in the UK: What It Is and When to Get One

Who should go for ovarian reserve testing?

As one of the best markers to understand female fertility, here are some reasons why you can opt for an ovarian reserve test:

• If you’re in your late 20s, 30s or 40s, and want to understand your fertility
• If you want to have kids in the future, but do not have a partner yet/or focusing on your career
• If you’re considering egg freezing/becoming an egg donor
• If you’re about to undergo chemotherapy/have had chemotherapy and want to preserve fertility
• If you have a medical history of genetic mutation, such as BRCA 1 (breast cancer gene), FMR1 (fragile X syndrome)
• If you’re nearing perimenopause and want to preserve fertility
• Medical history of early menopause or diminished ovarian reserve in the family 

How is ovarian reserve testing done?

Depending on the type of ovarian reserve test, it can either be a blood test or an ultrasound. 

Anti-Mullerian Hormone Test

The AMH test is a blood test that represents an accurate and indirect assessment of our ovarian reserve or egg count.

Let’s rewind here for a bit. Our ovarian reserve consists of follicles which contain eggs. Every month a group of follicles are recruited to produce the “egg of the month”. Think of these as growing from their baby stages (primordial, pre-antral) to teenage (antral) and adult (dominant) phase.

Of these, some undergo cell death, and only one follicle emerges as the dominant one.

AMH is produced by these primordial, pre-antral and antral follicles. 

“AMH is also known as a “functional ovarian reserve test” because the follicles selected in that cycle produce it” says Navya Muralidhar. “But our functional as well as overall ovarian reserve decline with age. So AMH is an accurate marker of ovarian reserve as well”

How is an AMH blood test done?

An AMH test is a simple blood test for egg count. It can be done at any point of the menstrual cycle and needs no preparation beforehand. 

• Once you book an AMH test you’d have to visit the clinic
• It's a quick blood test where the nurse or healthcare provider uses a small needle to draw a blood sample from a vein in the arm
• The sample is collected in a vial and sent to the lab for analysis

Post the analysis, you should receive a report outlining your AMH levels and what they mean for your age.

🌞Did you know?

When you get your AMH tested via Amilis, you get a personalised AMH report as well. The report includes your AMH levels, what they mean for your age, clear explanations and actionable steps tailored specifically to your needs. 

You'll also see how your egg quantity stacks up against others your age and gain personalized insights into what egg freezing could mean for you.

Antral Follicle Count

The Antral Follicle count is an ultrasound done on day 2 or 3 of the menstrual cycle that measures the number of growing follicles in that month. 

It is the sum of antral follicles (Follicles of size 2-10mm) in both ovaries as observed during days 2-4 of the cycle. 

The follicles taken into consideration are about 2-6mm in size. “This is because as we age, these are the follicles that reduce in number, giving us an estimate of our ovarian reserve”, says Navya Muralidhar.

Also read: AFC and Egg freezing: All You Need to Know

How is an AFC test done?

To get an AFC test done, you need to book an ultrasound appointment via Amilis or at a fertility clinic.

• A trained technician will perform the transvaginal ultrasound
• Here’s the bit you need to know about 😶‍🌫️As the name suggests- transvaginal- the ultrasound probe is covered with a condom and lubrication and gently inserted inside the vagina 
• The probe emits ultrasound waves internally, giving us a clearer image of the ovaries compared to an external ultrasound 

And while this is much different than a simple blood test, we get it, it can be a bit awkward at first 😬

However, there should not be a lot of discomfort and it should feel less invasive than a pap smear.

Which egg reserve test should I go for?

AMH and AFC both equally work well as screening tools to assess our ovarian reserve. But the type of test you choose may depend on your goals, your age and what information you’ve had so far.

• For someone who’s just starting out and wants to understand their fertility or egg count, AMH is the test to go for. It's a quick blood test that comes with a report that helps compare your age with AMH levels and what it could mean for your fertility.
• AMH is also preferred as it has very little intra-cycle and inter-cycle variability, compared to AFC where the values may slightly fluctuate based on cycle. 

📚Also read: Our guide on how to understand AMH results 

• For someone who’s already tested their AMH, or gotten a full hormone panel done, or is exploring options such as egg freezing, taking an AFC test would be the next step. We highly recommend talking to a healthcare provider prior. You can also get a free consultation via Amilis to get your AFC tested.
• AFC is also preferred at this stage because it is a better predictor of how many eggs can be retrieved in an egg-freezing or IVF cycle.

Ovarian reserve testing cost in the UK

In the UK, an Ovarian reserve test (AMH+ AFC) can cost somewhere between £200-400 when chosen via private clinics. The NHS does not cover or fund AMH treatment, so the costs via the NHS remain the same as clinic-listed prices. 

But there’s a much more affordable and accessible option out there- to get your ovarian reserve test done via Amilis.

Get your Ovarian Reserve Tested, via Amilis Fertility

About 751,000 women are waiting for gynaecological care in the UK, of which 30,000 women have been waiting more than a year for an appointment.

Be it egg freezing, getting a hormone panel done, or even an ultrasound appointment.

So at Amilis, we’re working to change this narrative and make reproductive care accessible and affordable in the UK

Here’s how:

• Get your AMH tested for just £80 (50% cheaper than fertility clinics), discounts on AFC scans and get personalised, free reports
• You can also opt for a full hormone panel at discounted costs 
• Free consultations with top fertility clinics and doctors, at your convenience
• Match with fertility specialists and expert doctors for your needs, with no waiting times

And throughout, you’ll have us supporting you on your journey 👯

Figuring out where to get started? Book a free call, or take our personalised fertility quiz to know more!

We’re bridging the healthcare gap for millions of women in the UK, one day at a time 💪🏻

Frequently asked questions 

1. Is there a blood test for ovarian reserve?

Yes, there are blood tests that can help evaluate your ovarian reserve. The main test is the AMH (Anti-Müllerian Hormone) test, which can be done on any day of your menstrual cycle. Another common test is the FSH (follicle-stimulating hormone) test, which is typically done on day 3 of your cycle. Your doctor may recommend one or both of these tests to assess your ovarian reserve.

2. How to test your egg count?

While it's not possible to count your exact number of eggs, doctors can estimate your ovarian reserve through several methods. This typically involves blood tests to check your AMH levels, combined with an ultrasound scan to count antral follicles in your ovaries. 

3. Is there an egg quality test?

Currently, there isn't a direct test for egg quality. But doctors can get clues about egg quality through several indicators. Age is the most reliable predictor of egg quality, and your doctor will consider this along with hormone testing results. If you're going through IVF, genetic testing of embryos can provide additional information. Your doctor will also look at your overall reproductive health assessment to evaluate potential egg quality.