What does an AMH test tell you about fertility?

An AMH (Anti-Müllerian Hormone) test measures the level of a hormone produced by follicles in the ovaries, providing an estimate of a woman's ovarian reserve – essentially, how many eggs she has remaining. Higher AMH levels suggest a larger egg supply and typically a better response to fertility treatment, while lower levels indicate diminished reserve. AMH does not measure egg quality directly, and it is not a definitive predictor of whether you can conceive. It is best interpreted alongside other evaluations, such as antral follicle count and hormonal testing, as part of a complete fertility workup.

How do doctors assess ovarian reserve?

Ovarian reserve is assessed through a combination of blood tests and imaging. The most commonly used tools are an AMH blood test, which can be done on any day of the cycle, and an antral follicle count (AFC) performed via transvaginal ultrasound, which counts the number of small follicles visible in the ovaries at the beginning of a cycle. Day 3 FSH and estradiol levels are also frequently included. Together, these measures give your physician a comprehensive picture of your egg supply to guide treatment planning and timing recommendations.

What hormone levels are measured during fertility testing?

A standard female fertility hormone panel typically includes follicle-stimulating hormone (FSH) and estradiol – both measured on cycle day 2 or 3 to assess how the pituitary is signaling the ovaries – as well as luteinizing hormone (LH), which triggers ovulation; anti-Müllerian hormone (AMH) for ovarian reserve; prolactin, elevated levels of which can suppress ovulation; and thyroid-stimulating hormone (TSH), since thyroid dysfunction is a frequently overlooked contributor to fertility difficulties. Depending on your history, additional hormones such as progesterone or androgens may also be tested.

Will I need an ultrasound as part of my fertility testing?

In most cases, yes. Transvaginal ultrasound is a standard component of a female fertility evaluation. It provides real-time visualization of the uterus and ovaries, allows your physician to count antral follicles for ovarian reserve assessment, and can detect structural concerns such as fibroids, polyps, cysts, or uterine abnormalities that may not appear on bloodwork alone. The procedure is minimally uncomfortable and does not require sedation.

When should I start fertility testing if I'm over 35?

If you are over 35 and have been trying to conceive for 6 months without success, it is recommended that you seek a fertility evaluation. However, there is no reason to wait the full 6 months if you have known risk factors, such as irregular cycles, a history of pelvic surgery, endometriosis, or prior miscarriages. Because ovarian reserve and egg quality decline more noticeably in the mid-to-late 30s, earlier evaluation can be especially valuable for understanding your current fertility status and identifying the most effective path forward.

Does insurance cover female fertility testing?

Many fertility diagnostic tests, including bloodwork, ultrasounds, and certain procedures, may be covered by your health insurance, depending on your plan. New Jersey's fertility insurance mandate provides coverage requirements that apply to many employer-sponsored plans in the state, making diagnostic testing more accessible than in many other states. Coverage varies by insurer, plan type, and specific diagnosis, so we recommend contacting your insurance provider before your appointment. RSCNJ's team is also available to help you understand your benefits and navigate your options.

Fertility Testing for Women | Reproductive Science Center of New Jersey

Explore How Female Infertility Is Diagnosed

Every woman's fertility journey is unique, shaped by her age, medical history, reproductive goals, and a range of biological factors that can only be understood through proper evaluation. Fertility testing is the essential first step in that process. Whether you have been trying to conceive for some time, are planning ahead for the future, or simply have questions about your reproductive health, testing gives you real answers rather than uncertainty.

At the Reproductive Science Center of New Jersey (RSCNJ), our board-certified reproductive endocrinologists design individualized testing plans to uncover what is happening and guide the most informed, personalized care possible. Understanding your fertility is not about finding problems; it is about finding your path forward.

What are the signs of female infertility, and when should I get tested?

Female infertility does not always announce itself. While some women experience noticeable symptoms, such as irregular or absent periods, very painful menstruation, or a history of miscarriage, many causes of infertility are entirely silent. A woman may feel completely healthy and still face challenges conceiving due to factors that can only be detected through testing.

Clinically, infertility is defined as the inability to conceive after 12 months of regular, unprotected intercourse. For women over age 35, that threshold drops to 6 months, given that ovarian reserve and egg quality decline more rapidly with age. However, you do not need to wait to seek an evaluation. Earlier testing is recommended if you:

Have irregular, infrequent, or absent menstrual cycles
Have been diagnosed with PMOS, endometriosis, or uterine fibroids
Have a history of pelvic inflammatory disease (PID) or sexually transmitted infections
Have experienced one or more miscarriages
Have undergone prior pelvic or abdominal surgery
Are considering egg freezing or future family planning

Testing is also appropriate for individuals who are not yet trying to conceive but want to understand their fertility potential before making important life or family-planning decisions.

Possible Causes of Female Infertility

A thorough fertility evaluation can help identify a wide range of conditions that may be affecting your ability to conceive, including:

Polyendocrine Metabolic Ovarian Syndrome (PMOS): A hormonal condition that disrupts ovulation and is one of the most common causes of female infertility.
Endometriosis: A condition in which tissue similar to the uterine lining grows outside the uterus, potentially affecting the ovaries, tubes, and pelvic environment.
Uterine fibroids or polyps: Benign growths within or near the uterine cavity that can interfere with implantation or embryo development.
Blocked fallopian tubes (tubal factor infertility): Scarring or blockages that prevent sperm from reaching the egg or the fertilized egg from traveling to the uterus.
Primary ovarian insufficiency (POI): A condition in which the ovaries stop functioning normally before age 40, resulting in reduced egg supply and irregular hormone levels.
Hormonal imbalances: Disruptions in FSH, LH, estradiol, prolactin, or thyroid hormones can impair ovulation and reproductive function.
Low ovarian reserve: A diminished supply of eggs relative to what is typical for a woman's age, which may reduce the chances of conception.
Irregular or absent ovulation (anovulation): Ovulation disorders are among the most treatable causes of infertility and can often be addressed with medication.
Pelvic adhesions or scarring: Scar tissue from prior surgery or infection can distort pelvic anatomy and affect reproductive organ function.
Genetic or chromosomal conditions: Certain inherited disorders can affect egg quality, ovarian function, or the risk of passing conditions to a child.
Recurrent pregnancy loss: Repeated miscarriages may signal an underlying anatomical, hormonal, genetic, or immunological issue that warrants investigation.
Unexplained infertility: In some cases, standard testing does not identify a clear cause, and further or more advanced evaluation may be needed.

What is AMH testing and why does it matter?

Anti-Müllerian Hormone (AMH) testing is one of the most important and widely used tools in female fertility evaluation, and for good reason. AMH is a hormone produced directly by the small follicles in the ovaries, making it one of the most accurate available indicators of a woman's ovarian reserve: the quantity of eggs she has remaining.

Unlike other hormonal tests that must be timed to a specific point in the menstrual cycle, an AMH blood test can be performed on any day, making it particularly convenient and accessible. Results are typically available within a few days.

What do AMH levels mean?

Higher AMH levels: generally suggest a larger ovarian reserve, which is associated with better response to ovarian stimulation and a wider range of treatment options.
Lower AMH levels: indicate a diminished ovarian reserve, which may mean fewer eggs available for retrieval and a more limited window for conception — naturally or with assistance.
Very high AMH levels: can sometimes be associated with polyendocrine metabolic ovarian syndrome (PMOS), where many small follicles are present but ovulation may be irregular.

AMH levels naturally decline with age – most significantly after the mid-30s – but they can also be lower than expected in younger women due to genetic factors, prior surgery, or autoimmune conditions. Knowing your AMH level early gives you valuable insight into your reproductive timeline and helps your physician tailor a care plan that is realistic, timely, and right for your individual situation. AMH alone does not determine your ability to conceive, but it is a critical piece of the overall fertility picture.

What other female fertility testing is part of an overall evaluation?

Depending on your age, history, and initial test results, your RSCNJ physician will recommend one or more of the following evaluations as part of a comprehensive fertility workup:

Medical History and Physical Examination

Every evaluation begins with a thorough review of your personal and family medical history, menstrual patterns, prior pregnancies, surgical history, and any known conditions. A physical examination helps identify structural or anatomical concerns that may not appear on lab results alone. This foundational step ensures that all subsequent testing is targeted and appropriate for your specific situation.

Ovulation Assessment

Regular ovulation is essential for natural conception. Ovulatory function can be assessed in several ways, including cycle tracking and basal body temperature charting, mid-luteal phase progesterone blood tests to confirm that ovulation has occurred, and transvaginal ultrasound monitoring to observe follicle development in real time. Identifying ovulatory disorders, such as anovulation or luteal phase defects, is an important step, as many of these conditions are highly treatable.

Hormonal Testing

Reproductive hormones play a central role in regulating the menstrual cycle, ovulation, and uterine receptivity. Standard hormonal panels at RSCNJ typically include follicle-stimulating hormone (FSH) and estradiol, measured on cycle day 2 or 3 to assess pituitary signaling and ovarian response; luteinizing hormone (LH), which triggers ovulation; prolactin, elevated levels of which can suppress ovulation; and thyroid-stimulating hormone (TSH), since thyroid dysfunction is a common and correctable contributor to fertility challenges. Hormone results are interpreted in the context of your full clinical picture, not in isolation.

Ovarian Reserve Testing

Ovarian reserve refers to the quantity and, to some extent, the quality of a woman's remaining egg supply. Testing typically includes an AMH blood test alongside a transvaginal ultrasound to perform an antral follicle count (AFC), a direct visual assessment of the number of small follicles visible in both ovaries at the start of a cycle. Together, AMH and AFC provide a comprehensive picture of ovarian reserve that is essential for treatment planning, particularly for women considering IVF or egg freezing.

Hysterosalpingography (HSG)

A hysterosalpingogram (HSG) is an outpatient X-ray procedure used to evaluate the uterine cavity and the patency of the fallopian tubes. During the procedure, a small amount of contrast dye is introduced through the cervix, and X-ray imaging tracks how the dye flows through the uterus and tubes. Open tubes allow the dye to flow freely; blocked tubes will show a stoppage. The HSG is typically performed in the follicular phase of the cycle and takes approximately 15 to 30 minutes.

Transvaginal Ultrasound Testing

Transvaginal ultrasound is a core tool in fertility evaluation and monitoring. Using a small probe placed just inside the vagina, this imaging technique provides a clear, real-time view of the uterus, ovarian structure, and follicle development. It is used to assess the uterine lining and cavity, count antral follicles for ovarian reserve assessment, identify structural abnormalities such as fibroids, polyps, or cysts, and monitor follicle growth during treatment cycles. The procedure is minimally uncomfortable and does not require sedation.

Laparoscopy

Laparoscopy is a minimally invasive surgical procedure performed under general anesthesia that allows a physician to directly visualize the pelvic organs. Using a small camera inserted through a tiny incision near the navel, the surgeon can identify and often treat conditions such as endometriosis, pelvic adhesions, ovarian cysts, and other structural abnormalities that may not be detectable through imaging alone. Laparoscopy is typically recommended when clinical history or other test results suggest a hidden pelvic cause of infertility that warrants direct evaluation.

Genetic Testing

Genetic testing may be recommended for women with a personal or family history of chromosomal conditions, recurrent pregnancy loss, premature ovarian insufficiency, or known single-gene disorders. Carrier screening can identify whether you carry gene mutations that could be passed on to a child. In cases of recurrent miscarriage, chromosomal analysis of both partners – and sometimes of the pregnancy tissue itself – may provide important answers. Your physician will recommend appropriate genetic evaluations based on your specific history and concerns.

Saline Infusion Sonogram (SIS)

A saline infusion sonogram (SIS), also called a sonohysterogram, is an ultrasound procedure in which a small amount of sterile saline is gently introduced into the uterine cavity to provide enhanced visualization of the uterine lining. This technique is particularly useful for detecting intrauterine abnormalities such as polyps, submucosal fibroids, or uterine adhesions that may interfere with implantation. The SIS is a minimally invasive, in-office procedure that does not require sedation and provides detailed information about uterine health that a standard ultrasound may not fully reveal.

How much does female fertility testing cost?

The cost of female fertility testing at RSCNJ varies depending on which evaluations are recommended based on your age, history, and clinical presentation. Many standard tests, including bloodwork and ultrasounds, may be covered in part or in full by your health insurance plan.

New Jersey has one of the most comprehensive fertility insurance mandates in the country, and depending on your employer and plan type, a meaningful portion of your diagnostic testing costs may be covered. We recommend contacting your insurance provider ahead of your appointment to understand your specific benefits.

For any costs not covered by insurance, RSCNJ offers flexible financing options and payment plans to help make fertility care as accessible as possible.

Female Fertility Testing FAQ

An AMH (Anti-Müllerian Hormone) test measures the level of a hormone produced by follicles in the ovaries, providing an estimate of a woman's ovarian reserve – essentially, how many eggs she has remaining. Higher AMH levels suggest a larger egg supply and typically a better response to fertility treatment, while lower levels indicate diminished reserve. AMH does not measure egg quality directly, and it is not a definitive predictor of whether you can conceive. It is best interpreted alongside other evaluations, such as antral follicle count and hormonal testing, as part of a complete fertility workup.
Ovarian reserve is assessed through a combination of blood tests and imaging. The most commonly used tools are an AMH blood test, which can be done on any day of the cycle, and an antral follicle count (AFC) performed via transvaginal ultrasound, which counts the number of small follicles visible in the ovaries at the beginning of a cycle. Day 3 FSH and estradiol levels are also frequently included. Together, these measures give your physician a comprehensive picture of your egg supply to guide treatment planning and timing recommendations.
A standard female fertility hormone panel typically includes follicle-stimulating hormone (FSH) and estradiol – both measured on cycle day 2 or 3 to assess how the pituitary is signaling the ovaries – as well as luteinizing hormone (LH), which triggers ovulation; anti-Müllerian hormone (AMH) for ovarian reserve; prolactin, elevated levels of which can suppress ovulation; and thyroid-stimulating hormone (TSH), since thyroid dysfunction is a frequently overlooked contributor to fertility difficulties. Depending on your history, additional hormones such as progesterone or androgens may also be tested.
In most cases, yes. Transvaginal ultrasound is a standard component of a female fertility evaluation. It provides real-time visualization of the uterus and ovaries, allows your physician to count antral follicles for ovarian reserve assessment, and can detect structural concerns such as fibroids, polyps, cysts, or uterine abnormalities that may not appear on bloodwork alone. The procedure is minimally uncomfortable and does not require sedation.
If you are over 35 and have been trying to conceive for 6 months without success, it is recommended that you seek a fertility evaluation. However, there is no reason to wait the full 6 months if you have known risk factors, such as irregular cycles, a history of pelvic surgery, endometriosis, or prior miscarriages. Because ovarian reserve and egg quality decline more noticeably in the mid-to-late 30s, earlier evaluation can be especially valuable for understanding your current fertility status and identifying the most effective path forward.
Many fertility diagnostic tests, including bloodwork, ultrasounds, and certain procedures, may be covered by your health insurance, depending on your plan. New Jersey's fertility insurance mandate provides coverage requirements that apply to many employer-sponsored plans in the state, making diagnostic testing more accessible than in many other states. Coverage varies by insurer, plan type, and specific diagnosis, so we recommend contacting your insurance provider before your appointment. RSCNJ's team is also available to help you understand your benefits and navigate your options.

Comprehensive Female Fertility Testing in New Jersey

If you are ready to understand your fertility, or simply want answers before making important decisions about your future, the Reproductive Science Center of New Jersey is here for you. Our experienced, board-certified reproductive endocrinologists welcome women at every stage of the fertility journey, offering compassionate, expert care across three conveniently located New Jersey clinics in Eatontown, Lawrenceville, and Toms River.

Whether you are actively trying to conceive, planning ahead, or navigating a diagnosis, a fertility evaluation is one of the most meaningful steps you can take for your reproductive future. You deserve answers, and a team that truly listens. Reach out to us today to receive both.