Ovarian reserve refers to the number and quality of eggs in a woman’s ovaries. Ovarian reserve naturally decreases as women age and approach menopause. Some women experience this decline earlier in life (for unknown reasons). This is a common cause of infertility.
Studies show that women with better ovarian reserve tend to have better response to infertility treatments, such as ovarian stimulation for IVF. In general, if you produce more eggs, IVF has a higher success rate. Having more eggs at the IVF egg retrieval makes us more likely to have at least one high quality embryo available for transfer back to the uterus. In addition, these tests for ovarian reserve help us to determine the amount of medication you need to stimulate your ovaries.
Tests for Ovarian Reserve
We use these tests in combination to assess your ovarian reserve.
Follicle Stimulating Hormone (FSH)
FSH is a hormone that is measured by a blood test. Follicles that contain developing eggs make the hormone, estrogen. This hormone signals the brain (hypothalamus) to increase or reduce the amount of FSH made by the pituitary gland.
When only a few follicles are developing, estrogen levels are lower and more FSH is produced. This leads to higher levels of FSH during the early menstrual cycle (day 2-4). FSH levels greater than 10-11 mIU/mL may be a sign of reduced ovarian reserve.
Anti-Mullerian Hormone (AMH)
AMH is a hormone that is measured by a blood test. Follicles in the ovaries make AMH. The AMH level reflects the remaining egg supply in the ovaries.
With increasing female age, the number of eggs in the ovary decreases. Likewise, the AMH levels decrease with age. AMH level less than 1.0 ng/mL may be a sign of reduced ovarian reserve.
Antral Follicle Count (AFC)
AFC is a test that is performed by transvaginal ultrasound. The total number of small (antral) follicles in both ovaries are usually measured during the first few days of the menstrual cycle.
The number of ovarian follicles visible on ultrasound decreases with age. Fewer than 10 antral follicles may be a sign of reduced ovarian reserve.