Month: July 2026

If you have visited a fertility specialist recently and been told you need an AMH test, you may have wondered what that number actually means — and whether a low result means you cannot have children. Dr. Durga Vytla, a fertility and IVF specialist based in Gachibowli, Hyderabad, explains ovarian reserve in plain language so you can make informed decisions about your fertility journey.

What Is Ovarian Reserve?

Ovarian reserve refers to the quantity and quality of eggs remaining in your ovaries at any given time. Every woman is born with a fixed number of eggs — somewhere between one and two million — and that number declines throughout life. By puberty, this falls to approximately 300,000 to 500,000. By the time a woman reaches her late 30s, the number has fallen significantly further, and the rate of decline accelerates.

Unlike men, who continuously produce new sperm, women cannot generate new eggs. The eggs you have at any point in your life are the ones you were born with — and each month, a cohort of eggs is recruited, one matures and is released at ovulation, and the rest are lost. This is why time matters in fertility, and why ovarian reserve testing is such a valuable tool.

How Is Ovarian Reserve Measured?

1. AMH — Anti-Mullerian Hormone

AMH is produced by the small follicles in the ovaries, and its level in the blood gives a direct reflection of the number of remaining follicles — and therefore the approximate egg count. The key advantages of AMH as a test are:

•       It can be done on any day of the menstrual cycle — no need to wait for a specific cycle day
•       It is a blood test — quick, simple, and minimally invasive
•       It does not fluctuate significantly from cycle to cycle, making it a reliable snapshot

AMH levels decline with age, but they also vary between women of the same age. This is why two women who are both 32 years old may have very different fertility outlooks — one with an AMH of 3.5 ng/mL and another with an AMH of 0.8 ng/mL are in very different clinical situations.

2. Antral Follicle Count (AFC)

The Antral Follicle Count is performed via transvaginal ultrasound, typically on Day 2 or 3 of the menstrual cycle. The sonographer counts the number of small, resting follicles visible in both ovaries. These small follicles represent the pool from which eggs will be recruited for IVF stimulation.

A combined interpretation of AMH and AFC gives the most accurate picture of ovarian reserve. AMH tells us about the hormone signal; AFC tells us about the actual visible follicle pool.

3. Day 2 or 3 FSH

Follicle Stimulating Hormone (FSH) measured early in the menstrual cycle is an older but still useful marker. When ovarian reserve is low, the pituitary gland works harder — producing more FSH to stimulate the ovaries. An elevated FSH on Day 2 or 3 (typically above 10 to 12 IU/L) may suggest diminished reserve, and is interpreted alongside AMH and AFC for the full picture.

What Do AMH Levels Mean?

Does Low Ovarian Reserve Mean You Cannot Get Pregnant?

No — and this is the most important message. Low ovarian reserve does not mean zero fertility. It means that your egg supply is more limited than average for your age, and that time and strategy become more important.

Many women with low AMH conceive naturally or through IVF — but they benefit from acting sooner rather than later, and from working with a fertility specialist who can tailor their treatment protocol appropriately. A blanket protocol designed for a 28-year-old with normal reserve will not give the same results for a 36-year-old with low reserve — and that is exactly where individualised care makes the difference.

What Affects Ovarian Reserve?

Beyond age — which is the strongest predictor — several other factors can accelerate the decline of ovarian reserve:

•       Genetics: A family history of early menopause or premature ovarian insufficiency
•       Previous ovarian surgery: Removal of ovarian cysts or endometriomas can reduce the surrounding follicular tissue
•       Endometriosis: Particularly when it involves the ovaries, it can damage the follicle pool
•       Autoimmune conditions: Some autoimmune diseases can target ovarian tissue
•       Chemotherapy or radiation: Cancer treatment can significantly and sometimes permanently deplete ovarian reserve
•       Smoking: Shown to accelerate follicle loss and bring forward the age of menopause

Ovarian Reserve and IVF in Hyderabad — What to Expect

In IVF, ovarian reserve directly determines how many eggs are likely to be retrieved in a stimulation cycle. Women with higher reserve produce more eggs, giving the laboratory more embryos to select from. Women with low reserve may produce fewer eggs, meaning each egg is precious — and the stimulation protocol must be optimised carefully.

Dr. Durga Vytla tailors every IVF protocol in Hyderabad to the individual patient's ovarian reserve profile. For low responders, a modified stimulation approach and careful timing strategies are used to maximise the number and quality of eggs retrieved.

Who Should Get an Ovarian Reserve Test?

•       Any woman above 30 who is planning to start trying for a baby in the next 1 to 2 years
•       Any woman who is considering egg freezing for fertility preservation
•       Women with irregular periods, PCOS, or a history of ovarian surgery
•       Women with a family history of early menopause
•       Couples who have been trying to conceive for 6 to 12 months without success
•       Women about to undergo chemotherapy or radiation who wish to preserve fertility

Book a Consultation

Find out your ovarian reserve today. Book an AMH and fertility evaluation with Dr. Durga Vytla in Gachibowli, Hyderabad. One blood test can change how you plan your fertility journey.