When Is the Right Time for Ovarian Reserve Testing?
When people talk about the “biological clock” they’re talking about ovarian reserve and the unfortunate fact that women’s egg quantity and quality declines with age. Ovarian reserve testing at our DFW IVFMD fertility centers can tell you how fast your own clock is ticking so you can make smart decisions about your own fertility.
Ovarian reserve testing provides answers for women who can’t seem to get pregnant on their own but it’s not just for women with infertility. These tests can help any woman decide if she can afford to wait to start a family or if she needs to preserve her fertility now.
How we determine your ovarian reserve
The closer you get to menopause the less likely you are to have enough quality, chromosomally-normal eggs to get pregnant naturally. We all know women who became moms later in life, but the fact is that pregnancy rates are lower and miscarriage rates are higher in older women, especially after age 34. For some women, though, the egg aging process starts much earlier: in their 30s or even their 20s.
To measure ovarian reserve we typically perform three tests:
- Antimullerian hormone, or AMH
- Basal antral follicle count, or AFC
- Basal follicle stimulating hormone, or FSH
The AMH test measures blood levels of a specific chemical secreted by your “pool” of immature ovarian follicles and can give an estimation of your remaining egg supply. The AFC test uses sonogram to count the number of follicles on both ovaries at the beginning of your cycle. It reflects the number of eggs Mother Nature allows you to use each cycle.
The number of eggs allotted per cycle depends on your long- term egg reserve. If the egg reserve is low then nature will allow only a small number of eggs to come out per cycle in order to conserve eggs to help you avoid premature menopause.
Think of the AMH value as your egg Savings Account and the AFC as the Checking Account. At the start of each cycle a set number of eggs from the Savings Account will be transferred into the Checking Account for use during that cycle. Together, the AMH level (Savings Account) and the AFC (Checking Account) can provide an accurate assessment of your egg reserve.
An older test for ovarian reserve is the blood level of FSH during the first few days of your cycle. FSH is a hormone from the pituitary that prompts your ovaries to recruit eggs at the beginning of each cycle. As your egg reserve goes down your FSH level goes up. Overall, the FSH level is not as sensitive as the AMH and AFC in providing estimation of ovarian reserve. This is because baseline FSH only starts to rise once the remaining egg supply is very low. By the time the FSH level is elevated (>10 mIU/ml), you may not have much time left to try to conceive.
Better decisions about your fertility
Ovarian reserve testing is a good starting point for you and your fertility specialist to discuss when you should start trying to conceive and whether you may need fertility treatment such as in vitro fertilization (IVF), intrauterine insemination (IUI) or donor eggs.
To learn more about ovarian reserve testing, contact our DFW fertility centers.