A woman is born with a fixed number of eggs in her ovaries. The eggs are released every month once she starts menstruating. Her reserve comes to an end when she reaches menopause. The number of eggs will start decreasing as she gets older as they get depleted every menstrual cycle. The age at which a woman’s reserve ends differs from woman to woman. An ovarian reserve test for infertility helps us know how many eggs are left in a woman’s ovaries.
It is common knowledge that a woman’s fertility decreases with her age. Did you know you need not roughly guess a woman’s fertility status anymore? Did you know you can take an ovarian reserve test to know how fertile she is?
In This Article
- What Is Ovarian Reserve?
- What Is the Meaning of Ovarian Reserve Testing (ORT)?
- Factors That Affect Ovarian Reserve
- How Is Ovarian Reserve Testing Done?
- What Ovarian Reserve Testing Can And Can’t Tell
- When Should You Consider The Ovarian Reserve Test For Infertility?
- How Should You Prepare For Ovarian Reserve Test For Infertility?
- FAQ’s
What Is Ovarian Reserve?
Ovarian reserve is the number of eggs left in a woman’s ovaries for reproduction. In other words, it is the woman’s fertility potential.
The fertility potential varies from woman to woman. While some women have trouble conceiving in their 20s, some women get pregnant even after 40 years of age. Multiple factors affect a woman’s fertility. The higher the potential, the better her chances of conceiving. Similarly, the lower the potential, the lower her chances of getting pregnant.
Every woman’s ovarian reserve changes over time. The rate at which it diminishes will also accelerate as she ages. This is why a woman’s fertility comes down drastically when she crosses 35 years of age. The older she is the faster her eggs will diminish.
What Is the Meaning of Ovarian Reserve Testing (ORT)?
The test approximately measures how many more eggs or the level of eggs remaining in her ovaries at that particular point in time. A woman loses eggs every time she menstruates. While one egg is released, many are observed back into the body. So, a woman actually loses multiple eggs every cycle contrary to the common belief that she loses just one egg per cycle.
An ovarian reserve test will check how many follicles are left in the woman’s ovaries. The tests include both blood tests and ultrasound of the ovaries. It is an indirect method of estimating how much longer a woman’s fertility can last.
Ovarian reserve tests (ORTs) also help fertility specialists distinguish between normal and poor ovarian response. If the tests generate a poor response, the doctor may not recommend fertility treatment. A poor response indicates the quality of the eggs could be low and may not result in a successful pregnancy despite fertility treatments.
Factors That Affect Ovarian Reserve
A woman’s ovarian reserve is affected by the following factors:
- Age
- Health
- BMI
- Endometriosis
- Cancer treatments like chemotherapy/ radiation
- Ovarian surgeries if any
- Injuries or infections
- Genetic disorders
- Autoimmune disease/conditions
How Is Ovarian Reserve Testing Done?
Many tests are available to check a woman’s ovarian reserve. Some of the most commonly used tests are:
1. AMH
Anti-mullerian Hormone is produced in the small sacs in the ovaries called the follicles. The test helps determine the size of a woman’s ovarian reserve. Since it is a blood test that can be taken on any day of the menstrual cycle, it is one of the quickest and more commonly used tests.
2. FSH
Follicle Stimulating Hormone or FSH is produced in the pituitary gland and indicates the age of the woman’s ovaries. The pituitary glands produce hormones to regulate a woman’s menstrual cycle. The hormonal levels fluctuate throughout the menstrual cycle and are not considered a very reliable test by many doctors.
3. Estradiol
Estradiol is another hormone produced by a woman’s body through her menstrual cycle. Like FSH, Estradiol will also fluctuate and is also taken on the 3rd day of the cycle. Though not a very reliable test to determine the ovarian reserve, it can indicate if the reserve is low or high. Elevated Estradiol levels indicate a diminished ovarian reserve.
4. Antral Follicle Count
The AFC is a transvaginal ultrasound that measures the follicles. It gives a closer look at the ovaries and is considered very reliable. More the number of follicles, the larger the ovarian reserve.
In most cases, the doctor will take two tests for more reliable results – the AMH to check the blood and hormonal levels and the AFC to get a close look at the follicles.
What Ovarian Reserve Testing Can And Can’t Tell
An ovarian reserve test can tell if a woman has a high reserve or a low reserve of eggs. It can even tell the approximate number of eggs a woman has left in her ovaries, by measuring her follicles and calculating how many eggs are present in a follicle.
An ovarian reserve test cannot tell the following
- The reserve of eggs you have
- Whether the quality of the eggs is good enough for conception.
- If and when you can get pregnant
- Whether your conception will result in a successful pregnancy
When Should You Consider The Ovarian Reserve Test For Infertility?
An ovarian test is generally recommended when a woman is unable to conceive even after trying for a year. Fertility specialists advise couples to try for a year before they opt for fertility tests such as the ORT.
If a woman is over 30 or 35 years and is yet to conceive, she can take a test to understand how much reserve she has left. If the reserve is very low, she can expect a delay in conception.
Similarly, if a woman wants to freeze her eggs for future use, she can take the test to know how many eggs can be preserved in a cycle. She can retrieve these eggs anytime in the future and use them to get pregnant.
How Should You Prepare For Ovarian Reserve Test For Infertility?
You don’t need to prepare much for an ovarian reserve test. Each test has a different requirement.
The key is to talk to a medical expert – either your doctor or a nurse to understand the basic procedures for each of these tests. This will help you mentally prepare for what lays ahead.
Ovarian reserve tests are pretty simple basic blood and ultrasound tests.
While FSH, AMH, and estradiol are blood tests, antral follicle count is an ultrasound.
FSH, estradiol, and antral follicle tests are taken between day two and five of your menstrual cycle, So, you need to track your dates and consult your doctor after your menstrual cycle starts.
AMH can be taken on any day of your menstrual cycle.
An ovarian reserve test for infertility is essential when you are having trouble conceiving. It helps you understand how many eggs you may have left and how much longer you can keep trying. Remember, these tests can only determine the quantity and not the quality. Also, a good reserve does not guarantee pregnancy and you can still get pregnant despite a low reserve. Multiple factors in addition to the ovarian reserve affect pregnancy and its outcome.
FAQ’s
1. What is a Normal Ovarian Reserve Level?
Test results between 0.7 and 5.0 AMH levels are normal. Anything lesser than 0.7 indicates a low reserve, while more than 5.0 can indicate polycystic ovarian syndrome.
2. Can You Get Pregnant With Low Ovarian Reserve?
Yes, one can get pregnant despite a low ovarian reserve. Remember, a woman can conceive until she enters her menopause. However, successful conception depends on many other factors in addition to the ovarian reserve.
3. Are Ovarian Reserve Tests Accurate?
Ovarian reserve tests can approximately determine how many eggs a woman has left in her ovaries, by measuring the follicles. While these tests can tell you if you have a low, normal, or high reserve, they cannot tell anything about the quality of eggs.
