What is ovarian reserve? (Plus everything to know about testing in London)
Understanding what’s going on with your ovarian reserve can feel a little scary if you’re in the initial stages, but it’s something that quickly becomes central when you’re trying to conceive, gearing up for IVF, or wanting more clarity about your reproductive health as you plan for the future.
Your ovarian reserve test London guide – what to expect & where to go
In London, ovarian reserve testing is pretty widely available, but the kind of gut feeling and specific, end-to-end support you’ll get can vary a lot between providers and clinics.
That’s where expert-led care becomes particularly important – because when it comes down to testing as key as this one, feeling cared for and supported, with results properly explained in context, all need to be non-negotiables for you.
Fitzrovia Fertility is our go-to in London right now for ovarian reserve testing, as well as tailored treatments, holistic therapies for fertility, and all-around top-notch expertise.
Read on for our ovarian reserve testing Q&A with Dr. Shirin Khanjani, London-based Consultant Gynaecologist and accredited subspecialist in reproductive medicine, and Co-Founder and Medical Director at Fitzrovia Fertility, as she breaks down everything you need to know.
Q: Starting simple, what is ovarian reserve?
Ovarian reserve is a way of describing the number of eggs remaining in the ovaries at a given point in time. Think of it as a snapshot of quantity, not quality.
Women are born with all the eggs they will ever have, and this pool naturally declines with age. Fertility testing helps estimate how many eggs the ovaries may be able to recruit in response to stimulation, but it does not give a full picture of a woman’s ability to conceive naturally.
This is the foundation of ovarian reserve testing and why interpretation matters just as much as the result itself.
How is ovarian reserve testing done?
The answer usually involves a combination of blood tests and ultrasound assessment.
At Fitzrovia Fertility, this is typically structured as follows:
- Blood tests measuring AMH (anti-Müllerian hormone), FSH, and oestradiol
- A transvaginal ultrasound scan to assess antral follicle count (AFC)
- In some cases, LH and progesterone tests, if cycles are irregular or there is concern about ovarian function
This combination gives a more complete picture than any single test alone.
What does this look like in-clinic?
In practice, ovarian reserve testing is straightforward and usually completed in a single clinic visit.
The blood test measures hormone levels linked to ovarian activity, while the ultrasound counts small resting follicles in the ovaries. These follicles are known as the antral follicle count.
Together, these results help estimate how the ovaries may respond to stimulation, particularly in IVF or egg freezing cycles.
If you’re searching for an ovarian reserve test in London, most fertility clinics will offer both elements, although the depth of interpretation can vary significantly.
Q: When should we think about checking our ovarian reserve?
You might consider an ovarian reserve test in London if you want a clearer understanding of your fertility, or are planning ahead for the future.
It can also be helpful if you are thinking about fertility preservation, delaying pregnancy, or have been trying to conceive without success.
There are several situations where earlier testing is particularly useful:
- Endometriosis or previous ovarian surgery
- History of chemotherapy or medical treatment affecting the ovaries
- Family history of early menopause
- Irregular or absent periods
- Symptoms suggestive of premature ovarian insufficiency
It is also a standard part of planning IVF treatment, helping clinicians tailor stimulation protocols more precisely to your ovarian response.
Keen to learn more about planning IVF with Fitzrovia Fertility? See how Dr. Khanjani starts, pivots & builds a personalised IVF treatment protocol here
Q: Now, let’s talk results – what do they actually tell us?
AMH and AFC are the two most commonly used results markers in ovarian reserve testing in London and globally.
They mainly reflect:
- Expected egg numbers
- How the ovaries may respond to fertility medication
- Likely egg yield in IVF or egg freezing cycles
They help clinicians predict whether someone may produce a low, average, or high number of eggs during stimulation.
What they don’t reliably show is egg quality. Age remains the strongest predictor of egg quality and embryo development potential.
What is a good ovarian reserve number?
There is no single “good” ovarian reserve number.
AMH and AFC results vary widely between individuals and must always be interpreted alongside age, medical history, symptoms, and reproductive goals.
A result that looks reassuring in isolation may mean something different depending on your wider clinical picture. This is why ovarian reserve testing in London should always include proper consultation, not just a lab report with no clear follow up.
What is a low ovarian reserve?
Low ovarian reserve means the ovaries appear to have fewer recruitable eggs than expected for age or treatment planning.
It does not mean conception is impossible.
It may mean:
- Fewer eggs collected during IVF
- Lower embryo numbers
- A need for more tailored stimulation strategies
- Earlier discussion about fertility preservation or alternative options
The key point is timing and personalisation, not limitation.
What is high ovarian reserve?
A high ovarian reserve usually refers to elevated AMH levels and/or a high antral follicle count.
This is often seen in women with polycystic ovarian morphology or PCOS.
In IVF, it can lead to a strong egg yield, but it also requires careful monitoring because the ovaries may respond more strongly to stimulation, increasing the risk of over-response or ovarian hyperstimulation syndrome.
High ovarian reserve is not inherently “better” or “worse”, it simply changes how your treatment will be managed.
Q: For someone based in London, how would you recommend choosing a clinic for testing?
When looking for an ovarian reserve test in London, the key difference lies in interpretation.
A good clinic will offer:
- A detailed medical and reproductive history
- High-quality ultrasound alongside blood testing
- A consultation that explains results in context
- A clear link between results and your personal goals
This is particularly important if you have endometriosis, previous ovarian surgery, low AMH, or a more complex fertility history.
Q: What can patients expect at Fitzrovia Fertility?
At Fitzrovia Fertility, ovarian reserve testing is always integrated into a broader clinical picture rather than treated as a standalone result.
The process begins with a detailed consultation covering menstrual history, past pregnancies or losses, previous fertility treatment, endometriosis, ovarian surgery, chemotherapy exposure, and family history of early menopause.
This is followed by:
- AMH blood testing
- High-quality pelvic ultrasound assessing AFC and ovarian structure
- Evaluation of uterine and pelvic health, including signs of adenomyosis or endometriosis when relevant
Everything is then brought together in a specialist consultation, where results are explained clearly and directly in relation to your situation.
You’ll leave with a full understanding of what your ovarian reserve means, what it doesn’t mean, and what your realistic next steps could look like, whether that’s trying naturally, egg freezing, IVF, embryo banking, or ongoing monitoring.
Q: Finally, what are your top takeaways, especially if we’re at the very start of the process?
- First, ovarian reserve is about egg quantity, not egg quality.
- Second, age matters enormously, even when ovarian reserve markers look reassuring.
- Third, a low ovarian reserve result is not a final answer – it’s a signal to seek timely, specialist advice so decisions can be made with clarity and confidence.
Ready to book in for ovarian reserve testing in London? Connect with Fitzrovia Fertility here to get the ball rolling.
Want to hear more from their expert team? Read this one next: Thinking about booking your first couples fertility test? Follow this London consultant’s step-by-step
