Tests for Ovarian Reserve and What Fertility Markers Reveal

Between 2015 and 2017, it looked as if such insights into the future might soon be available to every woman through home tests. Several companies from various countries launched tests that claimed to estimate the number of remaining eggs or assess the risk of early menopause. Most of these tests targeted Anti-Müllerian Hormone (AMH) in the blood. The AMH level indicates whether the ovarian reserve corresponds to a woman’s age or deviates from it.

Another test, requiring only a cheek swab, analyzed single nucleotide polymorphisms (SNPs)—small genetic variations in the DNA sequence. Certain SNPs have been linked to reduced fertility or early menopause. However, this test did not gain popularity and is no longer available, and most AMH home tests have also disappeared from (online) pharmacies.

• AMH below 0.7 ng/ml suggests a reduced ovarian reserve, warranting further medical evaluation or fertility treatment.

• AMH above 3.8 ng/ml may indicate PCOS (Polycystic Ovary Syndrome), where a large number of follicles are produced. While this can cause fertility issues, it doesn’t necessarily mean infertility.

A “perfect” AMH level signals a healthy ovarian reserve—but only for the moment. Severe illness or certain medications can quickly change this. Moreover, the quantity of eggs does not equal quality. Additional tests, such as ultrasounds or invasive examinations, are needed to assess egg quality and overall fertility.

A new German home test called Avery measures not only AMH but also:

• Progesterone

• FSH (Follicle-Stimulating Hormone)

• LH (Luteinizing Hormone)

• Estrogen (E2)

• Prolactin

Abnormalities in any of these values can indicate potential fertility issues, but none of them alone fully explains reduced fertility. Factors such as egg quality, ovarian health, and male sperm quality are equally crucial.

For women with a strong interest in their reproductive health—or a family history of fertility issues—such tests may offer reassurance (or confirmation of concerns). However, if there is a real suspicion of infertility, visiting a gynecologist or fertility clinic is more effective. Only there can the ovaries be assessed via ultrasound, follicles counted, and ovarian volume measured—leading to more reliable insights into ovarian reserve. Health insurance may also cover the cost of AMH and other fertility marker tests when done in a clinical setting, along with any subsequent treatments.

• Fail to conceive despite good conditions,

• Have experienced multiple miscarriages, or

• Are suspected of having an undiagnosed chromosomal abnormality.

Some women are born with chromosomal variations, such as Triple-X Syndrome or Fragile X Syndrome, which often lead to early menopause. Knowing this early can be crucial for planning fertility. International research on genetic testing for fertility in women with normal chromosomes is ongoing, and future methods may eventually offer reliable predictions.