Ovarian Reserve Testing for Women Fertility
What is an Ovarian Reserve Test?
An ovarian reserve test is used by doctors to assess a woman’s fertility potential. The results are interpreted by comparing them to others in the same age group.
The test involves both a blood test and a transvaginal ultrasound to estimate the number of eggs. Women are born with a fixed number of eggs that they will have throughout their life; no new eggs are produced over time.
This fixed number is referred to as the ovarian reserve, and it naturally decreases with age. The results of the ovarian reserve test help in predicting how well a woman might respond to treatments such as In Vitro Fertilization (IVF).
It’s important to understand that ovarian reserve tests cannot definitively determine your fertility nor predict your ability to conceive naturally. Healthcare providers use the results to plan the next steps in fertility treatment.
When Should I Undergo an Ovarian Reserve Test?
Your doctor might recommend taking an ovarian reserve test if:
- You have a health condition that may have affected your egg count, such as cancer.
- You are planning to begin fertility treatments, including IVF.
How Can You Tell if You Have a Low Ovarian Reserve?
The only way to know if you have a low ovarian reserve is through a fertility evaluation conducted by your doctor.
How is the Ovarian Reserve Test Performed?
An ovarian reserve test serves as an indicator of how successful fertility treatments may be, but it does not measure the quality of your eggs or provide the exact number of eggs you have. The test typically involves measuring the following:
- Follicle-Stimulating Hormone (FSH): This hormone controls the growth of eggs in the ovaries. FSH is produced by the pituitary gland, which is located in the brain, and it stimulates the growth of follicles in the ovaries. Follicles are small, fluid-filled sacs that contain eggs. These follicles produce estrogen, which signals the pituitary gland to regulate FSH production. Healthcare providers typically measure FSH levels around the third day of your menstrual cycle.
- Anti-Müllerian Hormone (AMH): AMH is produced by the follicles in your ovaries. Since these follicles contain eggs, higher AMH levels indicate a greater number of eggs. AMH levels decline as you age, as the number of eggs decreases over time. Unlike FSH, AMH levels can be measured at any point during the menstrual cycle. AMH levels below 1 ng/mL may indicate that your ovarian reserve is diminishing, but this result does not predict your ability to conceive.
- Antral Follicle Count (AFC): AFC is a component of the ovarian reserve test that is performed via transvaginal ultrasound. It allows the healthcare provider to count the number of follicles in your ovaries. These follicles are where eggs develop. Your provider will perform the follicle count during the first four days of your menstrual cycle.
It is essential to understand that doctors use the results of this test as just one of many factors to evaluate your fertility.
What Factors Affect Ovarian Reserve?
Several factors can influence your ovarian reserve, with age being the most significant. Women are born with all the eggs they will ever have. Some women are born with more eggs than others. By the time you start menstruating as a teenager, you will have already lost millions of eggs.
During a typical menstrual cycle, several eggs attempt to become the dominant egg that will be released during ovulation. Even though your body releases only one egg each month, thousands of eggs are lost annually.
Other factors that may decrease the ovarian reserve include:
- Previous ovarian surgeries or problems with one or both ovaries.
- Chemotherapy or radiation treatments.
- A history of severe pelvic infections.
- A family history of early menopause.
Are There Any Risks Associated with the Ovarian Reserve Test?
No, there are no risks involved with taking an ovarian reserve test. It is a safe test that involves drawing blood from a vein in your arm and performing a transvaginal ultrasound.
What Are the Limitations of the Ovarian Reserve Test?
The ovarian reserve test provides insight into how you might respond to fertility treatment, but it doesn’t tell the whole story. While the test can estimate the number of eggs, it cannot determine the health or quality of these eggs.
For example, a person may have a normal ovarian reserve but have lower-quality eggs that fail to fertilize during IVF cycles. After the age of 35, studies show that egg quality begins to decline as well.
Other factors affecting fertility are not related to the quantity or quality of your eggs. Healthcare providers use ovarian reserve testing as part of a broader fertility evaluation to gain a comprehensive understanding of your reproductive health.
When Will I Get the Results?
Your doctor usually receives the test results within a week of the test being performed. Based on the ovarian reserve test results and any other fertility tests you’ve undergone, your doctor will work with you to develop a treatment plan.
What Do the Ovarian Reserve Test Results Mean?
The results of the ovarian reserve test help predict your fertility potential and your response to fertility treatments. While it can provide some indication of whether your ovarian reserve is lower than others in your age group, it doesn’t predict exactly when you’ll conceive or how many eggs you have left.
No single fertility test can predict your ability to conceive or respond to fertility treatments. Your healthcare provider analyzes all your fertility test results, including the ovarian reserve test, to create a treatment plan tailored to your needs.
How Accurate is the Ovarian Reserve Test?
Fertility tests are diagnostic tools that cannot predict the exact number of eggs you have, how long you have to conceive, or how much time you have before menopause. However, they are currently the most accurate tools available for healthcare providers.
When it comes to IVF treatment, the ovarian reserve test is crucial because the number of eggs and your response to hormonal medications are linked to the success of ovarian stimulation.
What is a Good Ovarian Reserve Level?
Normal ovarian reserve levels can vary between labs and healthcare providers, so results should not be interpreted or compared without the guidance of a healthcare provider. Defining a “good” ovarian reserve level is difficult because each test measures something different. Instead, your healthcare provider will look at the results of your blood tests and ultrasound to determine if your ovarian reserve falls within the normal range.
Can I Increase My Ovarian Reserve?
No, you cannot increase the number of eggs you have. You are born with a fixed number of eggs. However, you can influence the quality of your eggs. Lifestyle factors that can affect egg quality include:
- Eating a nutritious diet and taking vitamins.
- Getting enough sleep.
- Quitting smoking and avoiding alcohol.
How Can I Test the Quality of My Eggs?
There is no test to examine the quality of your eggs. Ovarian reserve tests estimate the relative number of eggs remaining, but they do not assess the quality of the eggs. You will only know the quality of your eggs when you begin IVF treatment.
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