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  1. What is Antral Follicle Count (AFC)?
  2. What is Serum Anti-Müllerian Hormone (AMH)?
  3. Why Test AFH and AMH Levels?
  4. What to Expect During Your AFH and AMH Testing
  5. Frequently Asked Questions
  6. Contact Us to Learn More

If you are planning to grow your family or simply want to understand your fertility health, ovarian reserve testing can provide important insights. We offer two key diagnostic tools in Antral Follicle Count (AFH) and Serum Anti-Müllerian Hormone (AMH) testing to evaluate your remaining egg supply and overall reproductive potential. These simple and effective tests help women of all ages make informed decisions about fertility, family planning, and treatment options.

What is Antral Follicle Count (AFC)?

Antral Follicle Count (AFH) is a fertility test that uses a transvaginal ultrasound to count the small, fluid-filled follicles in the ovaries. These “antral” follicles are typically between 2 to 10 mm in size, and each holds an immature egg. The number of antral follicles visible at the beginning of a menstrual cycle gives your doctor a snapshot of your ovarian reserve or how many eggs you may have left.

This test is usually performed between days 2 and 5 of your menstrual cycle. A higher AFH suggests better fertility potential, while a lower AFH may indicate diminished ovarian reserve.

What is Serum Anti-Müllerian Hormone (AMH)?

Anti-Mullerian Hormone (AMH) is a hormone secreted by the small follicles in your ovaries. A simple blood test measures your AMH level, which correlates closely with your egg count (not egg quality). AMH can be tested at any point in your cycle. While higher AMH levels usually mean greater egg supply, lower AMH levels may signal reduced fertility.

Unlike other hormone tests, AMH levels remain stable and offer a reliable indicator of your fertility status and reproductive lifespan. AMH testing is especially useful for women considering egg freezing or ovarian stimulation fertility treatments such as in vitro fertilization (IVF).

“I love Dr. Tepper! He is straight forward, fast and very responsive. The office is warm & cozy and always clean. The staff are very friendly and always know your name when you walk in. Making appointments are easy and they’re usually able to work around your schedule. Dr. Tepper is a very busy OB/GYN doctor running his office while also running to the hospital to deliver babies. Dr. Tepper delivered my baby girl in November 2020 and helped me get through labor with ease. I would highly recommend him to any woman looking for prenatal care.”

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Why Test AFH and AMH Levels?

Measuring your AFH and AMH levels provides valuable information about your reproductive health. Whether you’re actively trying to conceive or planning ahead, these tests help you understand your fertility window and make proactive choices. By combining these two tests, our team can gain a comprehensive view of your ovarian function and fertility outlook. If needed, we can also test follicle stimulating hormone (FSH) and Estradiol levels.

What to Expect During Your AFH and AMH Testing

Both the Antral Follicle Count (AFH) and Anti-Müllerian Hormone (AMH) tests are quick, low-stress procedures that can be completed right in the office.

For the AFH test, you will undergo a transvaginal ultrasound, which is typically performed between days 2 and 5 of your menstrual cycle. This ultrasound allows us to view and count the number of small antral follicles in each ovary. The procedure is generally painless, takes about 10 to 15 minutes, and is conducted in a private and comfortable setting. A trained sonographer will perform the scan, and Dr. Tepper will discuss the results with you afterward.

The AMH test involves a simple blood draw and can be done at any point in your cycle. Once collected, the sample is sent to a laboratory to measure your AMH levels. Results are usually available within a few days and will be reviewed with you during a follow-up consultation to help guide any next steps in your fertility plan.

There is no special preparation required for either test. You can return to your normal daily activities immediately following your appointment.

MEET DR. ALEX TEPPER

Welcome to my practice. Let me introduce myself and my practice philosophy. I am a board certified OB/GYN in practice for over 20 years and have been a solo-practitioner on the Upper East Side of Manhattan since 2000. All deliveries are performed at The Mount Sinai Medical Center where I went to medical school and at Lenox Hill Hospital.

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Frequently Asked Questions

When is the best time to have an AFH test?

AFH is typically measured via ultrasound between days 2 and 5 of your menstrual cycle for the most accurate reading.

Can AMH levels fluctuate throughout the cycle?

AMH levels are relatively stable and can be tested at any point in your cycle.

Does a low AMH or AFH mean I can’t get pregnant?

Not necessarily. While low levels may suggest reduced ovarian reserve, many women with low AMH or AFH still conceive naturally or with fertility treatments.

Can AMH or AFH tests diagnose menopause?

These tests can help indicate whether a woman is approaching menopause, but they are not used alone to diagnose it.

Should I get AMH and AFH tests done even if I’m not trying to conceive right now?

If you’re curious about your fertility, planning for the future, or have concerns about irregular cycles or family history of early menopause, these tests can offer valuable insights.

Will AMH and AFH tests tell me if I can get pregnant?

It is important to note that no single test of ovarian reserve can definitively predict a woman’s ability to get pregnant. These tests are often used to develop a treatment plan, including the need for donor eggs or embryos.

Are AMH levels needed before IVF?

AMH is a marker for ovarian reserve and is often used to assess a woman's potential for fertility, especially in the context of IVF. While AMH is a key factor in IVF, it's just one piece of information. Other fertility tests may also be needed.

Can women with low ovarian reserve still pursue IVF cycles successfully?

Yes, women with low ovarian reserve can still undergo IVF cycles, though their response to fertility medications may be lower. In these cases, AMH hormone levels are often below the normal level, indicating the ovaries may produce fewer eggs. However, success is still possible. It’s important to remember that AMH levels naturally decline with age, so your provider will evaluate your full fertility picture, including your antral follicle count, hormone levels, and medical history (including any prior ovarian surgery), to create the best treatment plan for you.

What is ovarian hyperstimulation syndrome, and who is at risk during IVF cycles?

Ovarian hyperstimulation syndrome is a potential complication that can occur when the ovaries respond too strongly to fertility medications used in IVF cycles. Women with higher AMH hormone levels or conditions like polycystic ovary syndrome (PCOS) may be more prone to developing OHSS due to the production of a large number of follicles. While this may sound appealing to someone worried about fewer eggs or low ovarian reserve, it's important to strike a healthy balance. A high number of follicles doesn't necessarily mean all the eggs retrieved will be viable. Your doctor will closely monitor your ovarian reserve, hormone levels, and ultrasound results throughout treatment to help reduce the risk of OHSS and ensure a safer IVF experience.

Contact Us to Learn More

Ready to take control of your reproductive health? Dr. Tepper offers comprehensive fertility evaluations, including AMH and AFH testing, in a supportive and private setting. Contact us today to schedule your consultation and learn more about your fertility options.

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