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Four-marker baseline panel on days 2 to 5 — AMH, FSH, LH, and oestradiol — to predict ovarian response and guide IVF protocol planning.
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A four-marker panel measuring AMH, FSH, LH, and oestradiol on days 2 to 5 of the cycle.
Before starting IVF or ICSI, fertility clinics require a baseline assessment of ovarian reserve and pituitary function to predict how the ovaries will respond to stimulation medications. This four-marker panel provides precisely those markers.
AMH is the most reliable predictor of ovarian response: high AMH indicates a high number of recruitable follicles (and risk of ovarian hyperstimulation syndrome, OHSS); low AMH predicts a poor response and may indicate that a higher or modified stimulation protocol is needed.
FSH at baseline (days 2 to 5) is inversely related to ovarian reserve — elevated FSH signals that the pituitary is compensating for declining ovarian function. Basal LH and oestradiol contextualise FSH and identify early stimulation or residual follicular activity that could interfere with a new treatment cycle.
This panel is used by women preparing for an IVF consultation, monitoring ovarian reserve during or between IVF cycles, or seeking a private assessment before a first NHS fertility clinic appointment. Venous draw required on cycle days 2 to 5. GMC-physician reviewed results within 3 to 5 working days.
Understand what each marker measures, why it matters, and what the science says — not just a list of numbers.
The strongest predictor of ovarian response to stimulation; guides IVF stimulation dose and protocol selection.
Basal FSH on days 2 to 5; elevated FSH predicts diminished ovarian reserve and poor stimulation response.
Basal LH on days 2 to 5; LH-to-FSH ratio also relevant for PCOS identification before IVF.
Basal oestradiol; elevated early oestradiol can falsely suppress FSH and indicates residual follicular activity.
This panel is designed for adults who want a comprehensive, evidence-based picture of their metabolic health — not a GP referral panel.
Women preparing for their first IVF or ICSI consultation
Those between IVF cycles monitoring ovarian reserve recovery
Women considering egg freezing who want a baseline response prediction
Those seeking private baseline data before NHS fertility clinic appointments
This panel predicts ovarian response to stimulation but cannot predict embryo quality, implantation success, or live birth rates. AMH is an excellent predictor of egg number but not egg quality, which is the dominant determinant of IVF success after 35. A low AMH or high FSH does not mean IVF will fail; it means response may be lower and dose adjustments may be needed. Basal oestradiol must be measured on days 2 to 5; collection on other cycle days invalidates the FSH reference range. This panel does not replace the comprehensive assessment done by a fertility clinic, which also includes antral follicle count (AFC) on ultrasound — the most direct measure of recruitable follicles.
From order to physician-reviewed report in as little as three working days.
Three options designed to fit your schedule, location, and preference — all producing a laboratory-standard sample.
Adults 18+ in mainland UK. Not suitable if you have had a transfusion in the last 3 months.
Order anytime; kit dispatched within 24 hours Mon–Fri.
Allow 24–48 hours for sample transit on top of lab processing time.
Adults 18+ within 20 miles of a serviced city centre.
Mon–Sun, 06:00–20:00. Next-day booking typical.
Sample reaches the lab within 24 hours of collection.
Adults 16+ with photo ID. Paediatric draws by appointment at selected sites.
Mon–Fri, with Saturday hours at most metropolitan locations.
Samples processed same-day at the receiving clinic.
Every test is processed in a UKAS ISO 15189-accredited laboratory, overseen by GMC-registered physicians, and governed by UK GDPR. No overseas processing, no offshore data.
Follow these guidelines to ensure accurate, reproducible results. Most markers are sensitive to recent food, exercise, and sleep.
Can't find your answer? Our clinical support team is available Monday to Friday, 9am–5pm.
Contact supportFertility clinics use AMH (alongside antral follicle count on ultrasound) to personalise the starting dose of gonadotrophin (FSH or hMG) for ovarian stimulation. Women with high AMH (above 25 pmol/L) are at risk of over-response and OHSS, so they typically start with a lower dose of stimulation medication and may be offered an antagonist protocol to prevent a premature LH surge. Women with low AMH (below 5 pmol/L) are likely to produce fewer follicles per cycle, so a higher stimulation dose is typically prescribed, and a different protocol may be used. Knowing your AMH before your first fertility consultation allows the clinician to begin planning your protocol more efficiently.
Basal FSH (measured on cycle days 2 to 5) above approximately 10 to 12 IU/L is generally considered elevated and associated with diminished ovarian reserve and a lower expected response to IVF stimulation. FSH above 20 IU/L typically predicts a very poor response, and some clinics will not offer standard IVF in this setting, instead counselling egg donation or natural cycle IVF. However, FSH is not the only marker — women with elevated FSH and very low AMH have a better-characterised picture than FSH alone. Importantly, a single high FSH result can reflect a transient variation; if elevated, it should be confirmed in a subsequent cycle before firm clinical decisions are made.
Ovarian hyperstimulation syndrome (OHSS) is a potentially serious complication of IVF stimulation in which the ovaries over-respond to fertility medications, producing an excessive number of follicles, fluid accumulation, bloating, and in severe cases, breathing difficulties, blood clots, and hospitalisation. Women with high AMH are at substantially higher risk of OHSS because they have more recruitable follicles. Clinics use AMH to identify high-risk women and modify protocols accordingly — for example, using lower starting doses, freezing all embryos in a ‘freeze-all’ strategy to avoid a fresh transfer during OHSS, or using gonadotrophin-releasing hormone (GnRH) agonist trigger rather than the standard human chorionic gonadotrophin (hCG) trigger.
Yes. AMH, FSH, LH, and basal oestradiol are standardised assays used by both NHS and private fertility clinics. If your NHS fertility clinic has measured these markers, you can compare directly — though note that different laboratory platforms may produce slightly different numerical results for AMH (ensure you are comparing pmol/L values). Your physician report will include reference ranges and an interpretation that contextualises your results against published IVF response prediction thresholds. You can download the report and share it directly with your fertility consultant.
Elevated basal oestradiol (above approximately 200 pmol/L on day 2 to 5) provides negative feedback on the pituitary, suppressing FSH secretion. This means that FSH can appear falsely normal or even falsely low when, in reality, the ovarian reserve is compromised but the elevated oestradiol is masking this by suppressing FSH. Clinics therefore use FSH and basal oestradiol together — a ‘normal’ FSH in the context of an elevated basal oestradiol is less reassuring than a normal FSH with normal oestradiol. AMH is less susceptible to this confounding factor and is therefore a more reliable reserve marker independent of cycle dynamics.
