How To Check Your Ovarian Reserve

Ovarian reserve refers to the amount of eggs a woman has. Most women are born with about 2 million eggs (a newborn baby has even more – 20 million), and this reserve diminishes with time. A more rapid decline of eggs begins around age 37.

Research shows that one-third of couples have issues getting pregnant if a woman is over the age of 35., and getting your ovarian reserve checked could help you evaluate your fertility and plan for immediate or future pregnancies. 

How To Test Your Ovarian Reserve

A healthcare provider can test your ovarian reserve through a blood test that measures the follicle-stimulating hormone (FSH) and anti-mullerian hormone (AMH). An ultrasound measures the antral follicle count (AFC).

The pituitary gland in the brain releases FSH, which controls the growth of the eggs in the ovaries. The follicle – AKA egg sacs – releases estrogen, which responds to the pituitary gland to tell it to make more or less FSH. 

Levels of FSH fluctuate daily during a menstrual cycle, but if the FSH levels are too high or too low, this could create problems for fertility treatment. 

AMH is produced by the follicles, which contain eggs and are located within the ovaries. The hormone decreases as we age. The higher the AMH you have, the more eggs you might have. If your AMH levels are less than 1 nanogram per milliliter, this means your supply is declining, but it doesn’t necessarily mean you can’t get pregnant.

If a patient has a very high level of AMH, this could be indicative of polycystic ovarian syndrome (PCOS). Having too low of AMH could indicate premature menopause. Looking at AMH levels, which tend to be sensitive, is the best way for doctors to see if the ovarian reserve is aging. 

The AFC is tested by an ultrasound, which allows your doctor to count the number of follicles — where eggs develop — in your ovaries. 

The results of the testing can help a woman decide if she will respond to fertility treatment. 

The ovarian reserve doesn’t tell a person how fertile they are, however, it’s more of a tool for a woman to predict if they can possibly get pregnant on their own. The test doesn’t predict egg quality either, which starts to decline after the age of 35. 

Moreover, ovarian testing doesn’t inform a patient about how successfully she will respond to fertility treatment. It offers predictions but doesn’t offer a sure answer. A patient may have lower-quality eggs that don’t respond to in-vitro fertilization, which the test does not show. 

It’s important to know that there isn’t a singular test that predicts how successfully you will get pregnant or how successfully you’ll respond to fertility treatments. 

Who Should Get Their Ovarian Reserve Tested? 

A healthcare provider may encourage ovarian reserve testing if someone has had a condition that could impact their egg count or if they are interested in starting a fertility treatment. 

Many different factors impact your ovarian reserve. Age is probably the biggest factor, as eggs decline as we age. Once a woman starts menstruating, she’s already lost millions of eggs. 

Other reasons for the decrease of eggs include: 

• Ovarian surgery
• Chemotherapy
• Pelvic infections
• Early menopause 

There is no way to increase the number of eggs you have naturally but simple lifestyle changes like eating a nutritious diet, taking vitamins, getting a healthy amount of sleep, and avoiding smoking and alcohol can improve egg quality. 

If you are diagnosed with a low ovarian reserve, don’t stress too much. This doesn’t mean you won’t get pregnant. During IVF, gonadotropins, which are hormone injections, are given to the patient to stimulate the ovary to grow multiple eggs. If the ovarian reserve is diminished, higher doses of the hormone are administered. 

While getting your ovarian reserve tested is a great opportunity for those seeking fertility treatments, the biggest test involves the quality of eggs. And unfortunately, science and testing just aren’t there yet. Ultimately, you could have enough eggs, but the quality is of the utmost importance.

If you’re trying to conceive now, or later, getting your ovarian reserve checked can be a way for you to establish knowledge about your future as a mother. It can ensure that you’ll be prepared moving forward, and it’s necessary if you’re planning on seeking fertility treatments.