Infertility Education - Evaluating Ovarian Functions
The first step in a fertility evaluation is assessing a woman’s ovarian function. The ovaries play a very important role and have two main tasks:
- To produce eggs (oocytes) for fertilization. Specifically, one mature egg each month so that it can be fertilized.
- To produce estrogen and progesterone. Both of these hormones are essential to obtaining and sustaining a healthy pregnancy.
A woman is born with all the eggs she will have in her lifetime (approximately 6-7 million). As a woman ages, egg reserve declines until there is a total depletion of eggs, resulting in menopause.
Assessment of Ovarian Reserve
There are several ways in which we determine ovarian function:
Anti-Mullerian Hormone (AMH) level - AMH is a marker that indicates ovarian reserve.
- Determining AMH levels requires a blood test
- Normal AMH levels are between 1 - 3
- An AMH of < 1 may indicate diminished ovarian reserve, but this may vary based on a patient’s age
- An AMH > 3 may indicate PCOS (Polycystic Ovarian Syndrome)
- It is important to note that AMH levels do not determine if a woman will become pregnant
- Follicle Stimulating Hormone (FSH) & Estradiol (Estrogen) – Both FSH & Estradiol hormones provide another indication of properly functioning ovaries.
- Both of these levels are taken by blood draw between day 2 and 4 of your menstrual cycle
- An FSH of > 10 and/or an Estradiol level of > 70 may indicate reduced ovarian reserve
- Antral Follicle Count (AFC) - Antral follicles are tiny follicles seen only through an ultrasound. AFC is a good predictor of the number of follicles that will respond to stimulation medication.
- An assessment of the AFC via transvaginal ultrasound is given on day 3 of the menstrual cycle
It is important to remember that while ovarian reserve testing is a crucial part of the infertility evaluation, the testing is not definitive. It should be viewed as a screening test of ovarian reserve. The results of testing should not be used in determining whether or not a patient can undergo treatment. The true test of ovarian reserve is a stimulated cycle. While this information is helpful, there are many other factors that must be taken into account.
A provider from Buffalo IVF will consult with you about your results and answer any additional questions you may have. Based on the results and discussion, the provider will provide suggestions on the best course of treatment.