Ovarian Reserve Testing

Ovarian reserve is the female fertility potential ie how long you have left to have a baby.  Usually this naturally decreases with age but sometimes it can decrease faster or slower than expected.  Ovarian reserve is also extremely helpful in fertility treatment planning as it important as it can indicate what the response will be to the stimulation of the ovaries and the potential for success.

Ovarian reserve testing relates to the tests undertaken to understand a woman’s ovarian reserve.  In particular, there are two key tests when undertaking ovarian reserve testing; antral follicle count and AMH blood tests.  Together these two tests provide an accurate assessment of the female reproductive potential.

Antral Follicle Count

The antral follicle count is the number of antral follicles that are present at the beginning of the cycle and have the potential to grow and become competent follicles (antral follicles are small follicles (2-9 mm)  that we can see. measure and count. These can, with reasonable accuracy, be counted through vaginal ultrasound examination.  The sum of the antral follicles in the ovaries can indicate what the fertility potential is of the woman and importantly what the response will be to treatment involving stimulation of the ovaries, particularly for in-vitro fertilization (IVF).  Therefore, this is an important test in planning fertility treatments and understanding the success potential, for example:

• An antral follicle count of less than five usually indicates a low ovarian reserve, resulting in the need for relatively high doses of medication in order to produce a reasonable number of eggs for IVF.
• An antral follicle count of greater than 15, seen in such conditions as polycystic ovary syndrome, indicates a very good chance of harvesting a good number of eggs. This usually demands only a moderate dose of stimulating medication.
• Antral follicles may vary in women with lower egg count from cycle to cycle

Anti-Mullerian Hormone (AMH) Blood Test

Anti-Mullerian Hormone (AMH) hormone is a hormone produced by the ovarian follicles, therefore levels of AMH often relate to the number of antral follicles in the ovary but AMH levels in isolation depict the remaining lifespan of the ovaries, ie how much time is there left. The level of AMH in the blood can thus indicate how many egg-containing follicles are available in the ovaries with the potential to ovulate. In other words, the AMH level can tell us the size of the ‘ovarian reserve’.

AMH declines naturally with age and high levels can suggest polycystic ovaries, which is important when considering fertility treatments such as IVF.

Fertility Plus offers a complete package for ovarian reserve testing (initial egg count package) either to determine your fertility potential and how much time there is left or to help with fertility treatment planning.

• Up to 45 minute consultation with consultant fertility specialist
• AMH blood test
• An ultrasound scan to assess the follicles in your ovaries
• Results review with consultant fertility specialist