9 October 2018

Ovarian reserve and the chance of success

It has been widely proposed that the chance of success in IVF can be best predicted by a measurement of 'ovarian reserve'. How can that best be done - and why are experts excited about the hormone AMH?

The huge databases of the UK and American authorities leave no doubt that the chance of a live birth following IVF declines markedly with age. For example, data collected by the HFEA between 1992 and 2004 show that pregnancy rates in IVF begin their gradual but steady decline at around the age of 33 years. In the USA age-related pregnancy rates in IVF begin to fall below 40% once a woman reaches 34 years. By the age of 40, pregnancy rates have declined to 15-20%.

Ovarian reserve – a marker of IVF success

While age provides the greatest statistical prediction of success or failure in IVF, it does not give any true and precise indication in each individual patient. This depends more on the individual quality and quantity of the eggs stored within the ovary and how they will develop and become ready for fertilisation. Ability of the ovaries to generate viable eggs from the earliest follicles in the ovaries is called ovarian reserve. This is one of the most predictive markers of success in IVF.

While overall measures of ovarian reserve also decline with time and age, the rate of this decline varies considerably from one woman to another. For instance, two women at the age of 35 may have quite different measures of ovarian reserve, even though their chronological age is the same. That's why a precise measurement of ovarian reserve is an important step in our ability to predict IVF outcome, especially in women over the age of 35, when their chances of success begin to decline.

Counting on your follicles

A measurement of the total number of the earliest 'primordial' follicles within the ovary is simply not possible, but counting the later developing 'antral' follicles in the ovary provide a reliable alternative. Unlike primordial follicles in the ovary, antral follicles can be seen and counted at the time of the ultrasound scanning.

A high number of antral follicles would suggest an adequate ovarian reserve - and thus a good chance of pregnancy in IVF. Now, however, antral follicle count may be superseded by a more sensitive and predictive measure of ovarian reserve – an Anti Mullerian Hormone test.

Anti-Mullerian Hormone

In 2008 a review of several studies showed that the measurement of a single hormone - Anti Mullerian Hormone - was just as reliable as antral follicle count in predicting a poor response to IVF.

Anti Mullerian Hormone, or AMH, which can be measured from a blood test, is produced by cells from the outer layer of the follicle. The highest concentrations of AMH are found in the cells of preantral and small antral follicles - and are thus thought to correlate with the number of antral follicles within the ovary.

In recent years AMH has emerged as a predictor of ovarian response to drug stimulation in IVF.A study from Scotland has proposed that women with very low AMH concentration are at risk of either cycle cancellation or poor response to ovarian stimulation. While, those with medium levels have a good chance of a normal response, and those with very high levels may be at risk of ovarian hyperstimulation.

AMH and premature ovarian failure

Measurement of AMH has also been used to help confirm a diagnosis of premature ovarian failure, a distressing condition which can affect young women even in their twenties. While in many cases the exact cause remains unknown, a premature ovarian failure causes infertility as in affected women ovarian reserve had depleted much earlier than would normally be expected. As a result, ovulation and natural conception are no longer possible, and pregnancy can only be achieved by egg donation.

The the accuracy of AMH in predicting the outcome of IVF and ICSI treatment has been confined to studies assessing response to ovarian stimulation - whether a poor, normal or excessive response. Correlation of AMH levels with chances of natural conception are less conclusive. Occasional studies suggest that measures of AMH can help determine the most appropriate treatment approach for each individual patient.

Other factors to pregnancy success

AMH, like antral follicle count only represents the number of follicles present in the ovaries.The chance of pregnancy after IVF depends on much more than just follicle number - embryo quality, quality of the uterine lining, the transfer technique, whether the embryo implants within the uterus and other.

The LWC offers a Fertility MOT package which includes an AMH blood test and pelvic ultrasound scan to assess ovarian reserve. If you would like to find our more or book an appointment, please call 020 7563 4309 or contact us.

All of our blog posts are written, edited, or produced by the London Women's Clinic Content Team. This is a collaboration between our expert writers, health editors, and the leading researchers and senior doctors at our Harley Street clinic.

‘We have two beautiful children - our family wouldn't exist without LWC Brentwood. Can't recommend them highly enough; IVF is an emotional rollercoaster regardless of your journey and we were supported at every step. Pricing is transparent and easy to understand, with payment plans available that made accessing any treatment and medication very flexible and affordable. The clinic became such a part of our lives for that short time, the care and support is so important and LWC Brentwood were brilliant. Maybe we will see them again for number 3!’

Victoria Hayman

10 November 2026, LWC Brentwood

‘I would like to express my heartfelt thanks to the entire team for supporting me throughout my IVF journey. I am delighted to share that I had a positive pregnancy test following my very first IVF cycle fresh embryo transfer, and I am now 9 weeks pregnant! The staff at the LWC Colchester satellite clinic are very supportive, approachable and always do their best to help you at every stage of the journey. I would definitely recommend LWC Colchester to anyone considering fertility treatment. A special thank you to Dr Timea Kovats, a highly experienced, knowledgeable and to the wonderful staff Jackie, Annette, Tracey. Their excellent guidance, expertise, care and supportive approach played a significant role in making my first IVF cycle successful. I am truly grateful for their dedication, encouragement and support throughout this journey. I am equally grateful to all the staff at Colchester satellite clinic and the London main clinic for their care and support throughout the entire process. Thank you once again for helping us achieve such a special milestone in our lives. We will always be grateful for your support! ❤️’

jigu

10 November 2026, LWC Colchester

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Mizzee West

10 November 2026, LWC Brighton

‘The nursing team are so friendly and so supportive. Made everything so much better and easier to go through egg freezing.’

Megan Godber

10 November 2026, LWC Brighton

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Chiamaka Nelson

9 November 2026, LWC Cambridge

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Aruna Nelson

9 November 2026, LWC Cambridge

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Jessica Norman

9 November 2026, LWC Oxford

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Hannah Hale

9 November 2026, LWC Brighton

‘I honestly cannot recommend this fertility clinic highly enough. From the very beginning, the care, compassion and support we received were absolutely exceptional. Going through fertility treatment is an incredibly emotional journey, with so many ups and downs, but the team made us feel supported, listened to and genuinely cared for every step of the way. Nothing ever felt like too much trouble, and every member of staff we encountered was kind, understanding, professional and reassuring. What really stood out was how personal the experience felt. We never felt like just another number. The team took the time to answer our questions, put our minds at ease and guide us through what can sometimes feel like an overwhelming process. We are incredibly grateful for everything they have done for us and will never forget the part they have played in helping us grow our family. We now have our little miracles, and we couldn't be more thankful. If you're considering fertility treatment, I would wholeheartedly recommend LWC. Thank you from the bottom of our hearts for helping make our dream come true! ❤️’

Emma Hayman

8 November 2026, LWC Brentwood

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Kinga Arcana-Jones

7 November 2026, LWC Oxford

‘Everyone my partner and I have interacted with at the Oxford clinic has been warm, friendly and knowledgeable. They’ve really helped make a very daunting process easier to go through and I’m very glad we chose this clinic!’

Jess Palmer

5 November 2026, LWC Oxford

‘Very friendly staff and a lovely inclusive environment, had a wonderful experience here. Highly recommend for anyone looking at fertility preservation.’

T Ilagan

5 November 2026, LWC Oxford

‘As an LGBTQ couple we found LWC Colchester incredibly supportive, no question was too much. They were friendly and welcoming, with modern facilities, and made your journey feel very personalised. We would highly recommend them for your fertility journey.’

Jasmine Colman

5 November 2026, LWC Colchester

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James Purcell

5 November 2026, LWC Tunbridge Wells

‘Me and my husband can’t thank everyone at London Women’s Clinic enough for all the care and support throughout our recent treatment. Everything went really well, and we are so grateful to all the doctors and the entire team for looking after me. A special thank you to Mimi, Dr Barbara, Caroline, Trina and Elena from Embryology team and the Theatre Team - Rose, Martin and Amy F. Everyone was so kind, helpful and reassuring, and it really made a difference. Thank you all for everything. ♥️♥️♥️♥️♥️’

IsadelandCyril

4 November 2026, LWC Harley Street

‘I would like to express my heartfelt gratitude and appreciation to the entire team who supported us throughout our IVF treatment. ❤️ A special thank you to Ana-Maria,our nurse, for her kindness, patience, compassion and professionalism. She was always so caring, understanding and supportive, making us feel reassured and comfortable during such an emotional and challenging journey. We would also like to thank Dr Gill from the bottom of our hearts for his professionalism, dedication, expertise and the confidence he gave us throughout the entire process. IVF is not just a medical treatment; it is an emotional journey filled with hope, challenges and many feelings. Having such wonderful people by our side made everything so much easier. Thank you for your care, support and dedication. We truly appreciate everything you have done for us and would wholeheartedly recommend you to anyone beginning their IVF journey. Thank you for being part of our journey! ❤️’

Alexandru Predescu

3 November 2026, LWC Harrow

‘I would like to express my heartfelt gratitude and appreciation to the entire team who supported us throughout our IVF treatment. ❤️ A special thank you to Ana-Maria,our nurse, for her kindness, patience, compassion and professionalism. She was always so caring, understanding and supportive, making us feel reassured and comfortable during such an emotional and challenging journey. We would also like to thank Dr Gill from the bottom of our hearts for his professionalism, dedication, expertise and the confidence he gave us throughout the entire process. IVF is not just a medical treatment; it is an emotional journey filled with hope, challenges and many feelings. Having such wonderful people by our side made everything so much easier. Thank you for your care, support and dedication. We truly appreciate everything you have done for us and would wholeheartedly recommend you to anyone beginning their IVF journey. Thank you for being part of our journey! ❤️’

Mihaela-Clemansa Predescu

3 November 2026, LWC Harrow

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Ramachandran Jeyamohan

3 November 2026, LWC Colchester

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T Yang

3 November 2026, LWC Brentwood

‘We have used London Women's Clinic twice in the last two years for successful egg retrieval and two subsequent frozen embryo transfers. We have always been met with care, compassion and a personal approach. Every step from the initial consultation right through to the 7 week scan has been professional and polite, always accommodating our needs and timings. We can't thank the team enough for giving us such support towards creating our family.’

Lucy Richards

2 November 2026, LWC Tunbridge Wells

‘Myself and my husband owe it all to london womens clinic, they were amazing from start to finish. We previously were under another clinic and decided to make the change due to many reasons and we are so glad we did. They treat everyone as individuals, not everyones fertility journeys are the same. The small team at Colchester make it so personable not to mention how amazing all 4 women are that work here, their knowledge empathy and listening skills simply cannot be found at any other clinic. The list goes on as to why I would recommend LWC but everyone likes a to the point review. They genuinely care they dont treat you like a number and they help you through every hurdle that occurs. Our little boy wouldn't be possible without these 4, each of them play a bigger part than they realise. 💙’

Ellen Turrell

2 November 2026, LWC Colchester

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Yasmine Mora

30 October 2026, LWC London Bridge

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Louise

30 October 2026, LWC Oxford

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Luciana Lombardi

30 October 2026, LWC Cambridge

‘I had an absolutely amazing experience at LWC from start to finish! There are literally no wait times so we were able to get started pretty much straight away after consultation. The process was seamless, with a lot of flexibility if you need to change appt time. Nurses are amazing and so supportive. Special shout out to Kate and Chris who were so kind and made the whole experience so much better. Also the nurses on the ward were absolutely amazing but I can’t remember their names. I’m now discharged as I’m pregnant from my first try! However I will look forward to returning in the future for my second embryo which is currently frozen 😊’

Kathryn Jessica

27 October 2026, LWC Bromley