Best indicator of Ovarian reserve :

None of the ovarian reserve tests currently in use are accurate predictors for pregnancy With current methods, basal FSH concentration is simplest and most widely used to test ovarian reserve. Levels greater than 10 IU/L (10-20 IU/L) have high specificity (80-100%) for predicting poor ovarian response to ovulation. Serum FSH levels vary significantly across the cycle hence FSH is best measured during early follicular phase ( cycle day 2-4). Basal serum estradiol concentration has little value as ovarian reserve test. AMH: Antimullerian hormone is produced from preantral and small antral follicles hence AMH levels are gonadotropin independent and exhibit little variation within and between menstrual cycles. AMH threshold levels (0.2-0.7ng/ml) has 40-97% sensitivity, 70-92% specificity, 22-88% PPV and 97-100% NPV for predicting poor response to stimulation (<3 follicles or < 2-4oocytes). Reference: chapter 27; Female infeility; Clinical gynecologic endocrinology - eighth edition