Women are born will all of the eggs they will ever have, and over time, most of the eggs die without ever being ovulated. In a regular menstrual cycle, a woman will ovulate one mature egg and all of the other immature eggs will naturally die. Women peak in fertility in their early to mid-20’s and then begin a gradual loss in fertility over time that comes more pronounced in the mid-late 30’s.

Fertility Assessment Process:

  • Call SRM to schedule an Antimullerian Hormone (AMH) blood test. This test can be done at any time in your menstrual cycle and does not matter if you are on any hormonal birth control method. AMH is a hormone found only in ovarian follicles (eggs) and correlates with egg supply.
  • The second appointment will include an Antral Follicle count (AFC) transvaginal ultrasound to actually count the number of small follicles or eggs, and then a consult to review the results and briefly discuss options.

This chart illustrates the likelihood of pregnancy per month when actively trying to conceive based on age. It also explains the rise in miscarriage rates as women get older because of the increased number of abnormal eggs, the primary reason for miscarriages.

Ovarian Reserve / “Egg Supply”

Component: Data Table Block


Age303540>42
% Pregnancy/month15 - 20%10 - 15%5 - 8%4%
% Miscarriage15 - 20%20 - 25%30 - 40%>50%
%Genetically Abnormal Embryos25 - 30%40 - 60%70 - 80%>80%
Age 30 35 40 >42
% Pregnancy/month15 - 20%10 - 15%5 - 8%4%
% Miscarriage15 - 20%20 - 25%30 - 40%>50%
%Genetically Abnormal Embryos25 - 30%40 - 60%70 - 80%>80%

These pictorial ovals demonstrate an ovary and shows how an ovary at age 30 is much larger than an ovary at age 45. It also highlights how the total number of eggs decrease with age and the total number of abnormal eggs increase with age. The dots represent the follicles that can be seen on ultrasound, the half-shaped moon represents the overall egg supply that cannot be seen on ultrasound.

Follicles seen on ultrasound reflect a small fraction of the residual pool.

*Note, this illustration is an average. The absolute number and quality of eggs diminishes with age, but the number of follicles is variable for every woman. A younger woman may have a lower number of antral follicles but the quality is still good versus an older woman with a higher number of eggs but poor egg quality.

Q and A:

DO I HAVE TO DO THE BLOOD TEST OR ULTRASOUND ON A CERTAIN DAY OF MY CYCLE?
No, the fertility assessment can be completed on any day of your menstrual cycle.

WHAT IF I DO NOT HAVE PERIODS BECAUSE OF MY BIRTH CONTROL METHOD?
Your birth control will generally not interfere with the fertility assessment and you can do the test on any day that is convenient to you.

IS THE FERTILITY ASSESSMENT COVERED BY MY INSURANCE?
Your insurance may or may not cover the fertility assessment but our financial counselors will check for you. SRM provides a significant discount for fertility assessment, since we feel the education is so important.

WILL THE FERTILITY ASSESSMENT TELL ME IF I AM FERTILE OR NOT?
The fertility assessment is looking at your ovarian reserve or “egg supply”. This information may help you to make future life decisions. The absolute number and quality of eggs diminishes with age, but the number of follicles (eggs) is variable for every woman. A younger woman may have a lower number of follicles but the quality is still good versus an older woman with a higher number of eggs but poor egg quality.

Call SRM to schedule your Fertility Assessment at 877.777.6002.