Fertility and ovarian reserve (AMH)

Fertility and ovarian reserve blood test with anti-Müllerian hormone (AMH), FSH, LH, oestradiol, TSH and pooled prolactin. AMH estimates the follicle reserve and helps predict the response to ovarian stimulation, but it does not measure egg quality and does not on its own predict the chance of natural pregnancy.

No prescription or appointment needed

Results in 3-5 working days

Includes: Anti-Müllerian hormone · FSH · LH · Oestradiol · TSH · Pooled prolactin. See what each one measures

What it is for

It estimates ovarian reserve as part of a fertility assessment, before stimulation or when egg freezing is being considered. FSH, LH and oestradiol complete the early-cycle hormone axis, while TSH and prolactin look for hormonal causes that can disrupt ovulation.

The limit should be made clear: a low AMH does not mean infertility, and a high AMH does not guarantee pregnancy. Age remains the main factor linked to egg quality, and fertility also depends on ovulation, the fallopian tubes and sperm, which this blood test does not assess.

When it is recommended

Before ovarian stimulation or assisted reproduction treatment
Before considering egg freezing
A fertility assessment indicated after a period of trying without pregnancy
A family history of early menopause or a risk of reduced ovarian reserve
Assessment after ovarian surgery, endometriosis or treatments that can affect the ovary

Clinical comment

AMH is particularly useful for estimating how the ovary may respond to stimulation, not for predicting spontaneous pregnancy in a particular person. It can also be used in adult women as part of the PCOS criteria, but it should not be used as the only test and is not recommended for that diagnosis in adolescents.

We have included TSH and prolactin because a thyroid disorder or hyperprolactinaemia can interfere with the cycle. Pooling reduces the effect of stress on prolactin, although a high result still requires confirmation and context.

Bear in mind that hormonal contraceptives can temporarily lower AMH and change FSH, LH and oestradiol. The result should be read knowing whether they are being used, and without making decisions about reproductive timing based on a single number.

Dr. Antonio Mas

What is tested

Anti-Müllerian hormone (AMH): Related to the number of growing follicles, it helps estimate ovarian reserve and the expected response to stimulation.
FSH: Measured at the start of the cycle, it gives information about how the ovary responds to the signal from the pituitary gland.
LH: Involved in follicle maturation and ovulation.
Oestradiol: Helps interpret FSH and the hormonal state at the start of the cycle.
TSH: Picks up thyroid abnormalities that can affect the cycle and pregnancy.
Pooled prolactin: Looks for a persistent rise that could interfere with ovulation.

How to prepare

Have the sample taken between days 2 and 5 of the cycle so that FSH, LH and oestradiol can be interpreted. AMH on its own can be measured on any day. Come in the morning, with time to rest before the prolactin samples.

Mention contraceptives and other hormonal treatments. Do not stop them on your own.

You can add

Without another needle. It is offered when you order, so you do not have to decide now.

General blood testA general blood test with full blood count, glucose, cholesterol and kidney and liver function: the basic parameters included in any general check-up.+€59.00
General + nutritional blood testEverything in the general blood test (anaemia, kidneys, liver, cholesterol and glucose) plus iron stores, vitamin D, vitamin B12 and folic acid. It is the broadest add-on: it covers the general and the nutritional in one go.+€129.00
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Related blood tests

We have other profiles in Women with more or fewer tests:

The most comprehensive is not always the most useful. If you are not sure, the one we recommend to start with is Polycystic ovary syndrome (PCOS) blood test.

What it is based on

American Society for Reproductive Medicine · Fertil Steril 114(6):1151-1157
Testing and interpreting measures of ovarian reserve: a committee opinion
It confirms the two things this page says AMH does not do. AMH and the antral follicle count are currently the most sensitive markers of ovarian reserve, but the paper concludes that they measure the quantity of eggs well and reproductive potential poorly, and that they should not be used as a fertility test or to deny access to treatment. It is also the source for AMH barely varying within the cycle, which is what allows it to be measured on any day, and for hormonal contraceptives being able to lower it.
International PCOS Network · J Clin Endocrinol Metab 108(10):2447-2469
Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome
This is the international guideline that allows AMH to be used instead of ultrasound to assess ovarian morphology in adult women, and that adds that in adolescents it should not yet be used for that purpose. It also makes clear that one or the other is done, not both, to avoid overdiagnosis.

Protocol designed by Dr. Antonio Mas, specialist in Endocrinology and Nutrition, Spanish medical licence no. 080846289, and reviewed in September 2026.

This blood test is a standardised protocol and does not replace a medical consultation. If you have symptoms, a known condition or a complex clinical situation, speak to your doctor.