Key Fertility Tests Explained

Introduction

"I have my results, but I don't understand anything..." How many people have said this leaving the lab, an envelope in hand containing mysterious numbers? Fertility tests are often the first step on the journey, but they can feel intimidating. Understanding these tests lets you reclaim power over your path and communicate more effectively with your medical team.

Anti-Müllerian Hormone (AMH): An Indicator of Ovarian Response

What Is AMH?

Anti-Müllerian hormone (AMH) is produced by granulosa cells of small antral follicles (2–10 mm on ultrasound) and pre-antral follicles in your ovaries. Its blood level serves as a marker of your ovaries’ ability to respond to stimulation, notably in in vitro fertilization (IVF).

Imagine your ovaries as a factory: AMH indicates how many “machines are ready to start production” (antral follicles available for recruitment).

What AMH Does Not Directly Reflect:

• Total ovarian reserve of dormant eggs (primordial follicle pool): AMH doesn’t measure the entire stockpile of undeveloped eggs. Many non-antral (primordial and primary) follicles make up this true reserve but produce little to no AMH.

• Intrinsic fertility: A low AMH level does not mean you are infertile or unable to conceive naturally. It indicates a potentially reduced response to ovarian stimulation treatments.

How to Interpret Your AMH Results

These ranges are general guidelines and must be interpreted by a healthcare professional within your overall clinical context.

• AMH > 2.5 ng/mL: Expected good ovarian response to stimulation

• AMH 1.5–2.5 ng/mL: Expected satisfactory ovarian response

• AMH 0.5–1.5 ng/mL: Moderate response; specific treatment strategies may be considered

• AMH < 0.5 ng/mL: Poor response expected; tailored stimulation protocols and alternative approaches may be discussed

💡 Pro Tip: A low AMH doesn’t equal infertility. It mainly indicates a potentially reduced response to stimulation. Many women with low AMH can still conceive—either naturally or with tailored ART protocols. AMH is a decision-making tool for personalizing treatments.

Good to know

Our gynecologist’s note: If you’re under 35 and low ovarian reserve is detected, remember your age remains a major advantage. Egg quality often compensates for lower quantity, preserving your chances of natural conception.

FSH and LH: The Conductors of Your Cycle

The Role of FSH

Follicle-stimulating hormone (FSH) is produced by the pituitary gland. It stimulates ovarian follicle growth. The more encouragement your ovaries need, the more FSH your pituitary releases.

Reference FSH Values (Day 2–3 of Cycle):

• < 10 mIU/mL: Normal ovarian function

• 10–15 mIU/mL: Diminished ovarian reserve

• 15 mIU/mL: Poor ovarian reserve

LH: The Ovulation Trigger

Luteinizing hormone (LH) triggers ovulation. Its mid-cycle surge releases the mature egg. An LH/FSH imbalance can indicate polycystic ovary syndrome (PCOS).

Progesterone: A Marker of Your Ovulation

Why Measure Progesterone?

Progesterone is the hormone of the second half of the cycle. It confirms that ovulation has occurred and prepares the uterus for embryo implantation.

Sample Timing: 7 days after presumed ovulation (Day 21 in a 28-day cycle)

Interpretation:

• 10 ng/mL: Ovulation confirmed

• < 3 ng/mL: Ovulation doubtful or absent

🌟 Did you know? Progesterone is nicknamed “the pregnancy hormone” because it maintains the uterine lining. A deficiency can explain recurrent early miscarriages.

Additional Tests: Refining the Diagnosis

Transvaginal Ultrasound

Counts antral follicles (small follicles visible on ultrasound). This count corroborates AMH and assesses ovarian quality.

Semen Analysis: The Essential Male Test

In 40% of infertility cases, the cause is male-factor. Semen analysis evaluates:

• Ejaculate volume

• Sperm concentration

• Vitality

• Motility

• Morphology

💡 Pro Tip: Gentlemen, abstain from intercourse for 3–5 days before collection for optimal results. And avoid hot baths!

Understanding Variations: You Are Not a Robot

Factors That Influence Your Results

Your hormone levels can vary according to:

• Your age

• Your menstrual cycle

• Stress levels

• Body weight

• Certain medications

“My first results terrified me—my AMH was very low. But my gynecologist explained that this didn’t prevent me from having good-quality eggs. I had my daughter after 6 months of trying naturally!”

— Marie, 38

When to Repeat Tests?

Fertility tests can change over time. It may be relevant to repeat them:

• After 6 months if results are borderline

• If your situation changes (weight, stress, treatment)

• To adapt an ART protocol

Taking Action: What Now?

Talking with Your Doctor

Prepare your questions in advance:

• What do my results concretely mean?

• What strategy do you recommend?

• When should I repeat the tests?

Adopt a Holistic Approach

Tests are only a snapshot at a single moment. They guide the strategy but don’t determine your future. Take care of yourself:

• Balanced nutrition

• Appropriate physical activity

• Stress management

• Quality sleep

🔑 Key Takeaways

• AMH is an indicator of ovarian response but does not predict egg quality or natural conception chances.

• High FSH indicates your ovaries are working harder to produce follicles.

• Progesterone confirms ovulation and must be measured at the correct cycle phase.

• Results change over time and should be interpreted by a professional.

• *A global approach—medical testing plus healthy lifestyle—**optimizes your chances.

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💝 You Deserve Support

Your results do not define your worth or your chances of becoming parents. They are tools to personalize your journey. Don’t hesitate to ask for explanations, pose questions, and surround yourself with caring professionals who take the time to explain.