It refers to the ease at which an individual’s ovaries can be successfully stimulated with fertility drugs. The concept of ovarian reserve testing, therefore, represents a means by which the physician attempts to evaluate a woman’s reproductive potential both in terms of the number of follicles that remain and the health of those follicles
The egg quality is determined by a woman’s chronological age with peak female fertility taking place when a woman is in her twenties and then drops significantly with age, especially following age 35.
‘The single most consistent variable affecting ovarian reserve is the woman’s age. This is because a woman is born with all the eggs she will ever have. and majority of the eggs are genetically normal or balanced. However, there will be some that are genetically abnormal or unbalanced. It appears that the best eggs are ovulated first. The older a woman is, the fewer genetically balanced eggs she has left to respond to fertility drugs.’
Ovarian reserve test can be investigated in different ways:
- By measuring the follicle-stimulating hormone (FSH) on day 3 of a normal menstrual cycle. An estradiol level should be obtained at the same time, because the FSH level can be misleadingly low in women who have a high estrogen level early in the menstrual cycle.
- By performing a transvaginal ultrasound to chek the antral follicle count (AFC). AFC only measures the egg quantity, while the egg quality is mostly age related.
- Antimullerian hormone (AMH) is another blood hormone test that is often used to assess ovarian reserve. Many experts believe that AMH is a better indicator of ovarian reserve than serum FSH as it has less cycleto- cycle variability.
Women with low ovarian reserve are usually advised to consider: Invitro fertilization and donor eggs to enhance their conception.