Ovarian Reserve Testing
Almost one in ten women who present for infertility treatment will have such poor ovarian function that they are extremely unlikely to achieve pregnancy. At the current time, this problem cannot be fixed. Therefore, assessment of a woman’s is the most important fertility test that a physician does.
Women have all the eggs they are ever going to have in their lives before they are born. By the time of birth, the ovarian reserve – the number of remaining eggs stored in the follicles – has decreased dramatically. For the rest of her life, ongoing follicular depletion will reduce the number of eggs remaining in the ovaries. In fact, far more eggs will be lost by degeneration than are lost by ovulation.
There are a few different tests that can assess ovarian reserve: the clomid challenge test, antral follicle count, and ovarian volume assessment.
Ovarian reserve testing is not the same thing as testing for ovulation. A woman can ovulate normally and have very regular menstrual cycles and still have a poor potential for producing pregnancy. One author even coined the term “Occult Ovarian Failure” to describe the triad of infertility, regular menstrual cycles and decreased ovarian reserve.
Tests of ovarian reserve are only predictive of fertility when they come back ABNORMAL. A normal test does NOT mean that the ovaries work well. It just means that no test has yet demonstrated that they work poorly. These tests do not find all women with poorly functioning ovaries.
AMH levels (Anti-Mullerian hormone) Measurement of the hormone AMH in the blood
Clomid Challenge Test Assessment of FSH levels in the blood before and after taking a medication called Clomid.
Ovarian Volume Assessment The size of the ovaries can predict pregnancy potential.
Antral Follicle Counts Counting follicles seen by ultrasound can predict ovarian reserve