You walk out of the lab with a report that has six acronyms, three asterisks, and a flag that says "low" or "high" on something you have never heard of. Then you spend two hours on the internet getting more anxious than informed.

This is the explainer we wish every Indian woman got handed with her first fertility report. We will keep it simple, practical, and honest about what each number does and does not tell you.

AMH — Anti-Müllerian Hormone

AMH is the single best blood marker we have for estimating ovarian reserve — that is, the rough size of the remaining pool of eggs. It is produced by the small follicles in your ovaries, and it can be tested on any day of your cycle, which is part of why it has become so widely used.

What AMH tells you: a sense of where your ovarian reserve sits relative to women your age. Higher is generally better in fertility terms, though very high values can also flag conditions like PCOS.

What AMH does not tell you: whether you can or cannot get pregnant. AMH measures quantity, not quality. Many women with low AMH conceive naturally, and many women with high AMH face conception challenges. Treat AMH as one input, not a verdict.

Indicative reference ranges in Indian women:

• Under 30: 2.0 – 6.8 ng/mL
• 30–34: 1.5 – 5.0 ng/mL
• 35–39: 1.0 – 3.5 ng/mL
• 40 and above: under 1.0 ng/mL is common

FSH — Follicle-Stimulating Hormone

FSH is the hormone your brain sends to your ovaries to start growing follicles each cycle. It is tested on day 2 or 3 of your period, and it works in partnership with AMH.

What FSH tells you: how hard your brain is having to work to recruit follicles. When ovarian reserve is healthy, FSH stays low. When reserve is declining, FSH rises because your brain is shouting louder to get the same response.

Day 2/3 reference range: typically 4 – 10 IU/L. Values consistently above 10 may flag declining reserve and warrant a specialist conversation.

LH — Luteinizing Hormone

LH is what triggers ovulation. The mid-cycle LH surge is the signal that releases the egg from the dominant follicle.

Day 2/3 reference range: typically 2 – 10 IU/L. The clinically interesting number is the LH-to-FSH ratio. A ratio above 2:1 on day 2/3 can be one of several markers of PCOS — though it is not diagnostic on its own.

Estradiol (E2)

Estradiol is the main estrogen produced by your ovaries. On day 2 or 3, it should be low, because the cycle has not yet started building up. If day-2 estradiol is unexpectedly high, it can artificially suppress FSH and make a declining reserve look better than it is. Day 2/3 reference range: typically under 80 pg/mL.

TSH — Thyroid-Stimulating Hormone

Thyroid function and fertility are tightly linked. Even mildly abnormal thyroid levels can disrupt ovulation, contribute to miscarriage risk, and complicate pregnancy.

For women trying to conceive, most fertility specialists in India aim for a TSH under 2.5 mIU/L — tighter than the standard adult range. If yours is higher, even modestly, talk to your doctor about whether a thyroid review is needed.

Prolactin

Prolactin is the hormone responsible for milk production. When it is unexpectedly elevated outside of pregnancy or breastfeeding, it can disrupt ovulation. High prolactin is one of the most common — and most reversible — reasons for cycle irregularity. Reference range: typically under 25 ng/mL. If yours is higher, your doctor will usually retest before deciding on next steps.

Vitamin D

Vitamin D deficiency is extremely common in Indian women — by some estimates, over 70% of urban Indian women are deficient. While it is not a direct fertility hormone, low vitamin D is associated with cycle irregularity and is one of the easiest things to correct. Aim for: 30 – 50 ng/mL. Below 20 is deficient and worth correcting before serious fertility planning.

Putting the report together

No single number on a fertility report is a verdict. Doctors read these in combination, and in context — your age, your cycle history, your symptoms, your goals. A "flagged" value on a printout often turns out to be unremarkable in context. A normal-looking report can sometimes hide an issue that only emerges with deeper investigation.

That is why we always recommend a 20–30 minute report review with a fertility specialist before you draw conclusions. The numbers on their own are data; the interpretation is what makes them useful.