What ovarian reserve testing?
During infertility evaluation, doctors commonly perform testing to assess low ovarian reserve. These tests measure the number of eggs remaining in a woman’s ovaries and evaluate the potential for fertility, which tends to decrease as a woman gets older.
Why do doctors perform ovarian reserve tests for fertility evaluation?
Ovarian reserve testing evaluates the number and quality of eggs that remain in a woman’s ovaries. It provides a measure of the potential for fertility, which decreases as a woman gets older.
Doctors often conduct ovarian reserve testing as part of a fertility evaluation to assess a woman’s fertility potential and determine the most appropriate fertility treatment. Doctors can also use it to monitor the effectiveness of fertility treatment or assess the risk of early menopause.
Common tests to measure the egg pool (reserve)
Medical professionals usually perform testing using a blood sample or an ultrasound, providing a simple and non-invasive way to assess fertility potential and guide fertility treatment.
There are several methods to assess ovarian reserve actively:
- Anti-Müllerian hormone (AMH) test: This blood test measures the level of AMH, indicating a higher egg reserve with a high level and a lower egg reserve with a low level.
- Antral follicle count: This ultrasound-based test involves counting the number of small, fluid-filled sacs called antral follicles in the ovaries, where a higher count suggests a higher egg reserve.
- Follicle-stimulating hormone (FSH) test: This blood test measures the level of FSH, with a high level indicating a lower egg pool and a normal or low level suggesting a higher egg pool.
- Ovarian ultrasound: This ultrasound test actively assesses the size and appearance of the ovaries, where changes in size or appearance may indicate a lower ovarian reserve.
What is the best test to measure the egg reserve?
Fertility specialists regard AMH and AFC as the best and most accurate tests for measuring egg reserve in the ovaries. You can undergo an AMH test at any time during the cycle. A fertility specialist or sonologist must perform AFC on day 2 or day 3 after your periods start. Improper sample handling and testing may affect the accuracy of AMH results.
Does the egg reserve change with age?
Ovarian reserve in women decreases with age. This decline is reflected by a drop in AMH and AFC values and an increase in day 2 FSH values.
The diagnosis of poor ovarian reserve is a binary answer based on cutoffs for specific tests and does not depend on age.
What are the cutoffs to define a normal versus poor ovarian reserve?
The following results indicate a good ovarian reserve regardless of age:
- An AFC value of 5 or greater is considered normal, while values below 5 suggest a low reserve.
- An AMH value greater than 1.0 ng/mL indicates a normal reserve, while values below 1.0 ng/mL suggest a diminished reserve.
- On day 2 of the cycle, an FSH level lower than 10 mIU/L (Note: low FSH is favorable) is indicative of a normal reserve. Values equal to or greater than 10 suggest a diminished reserve.
Diminished Ovarian Reserve in Indians
Poor ovarian reserve (POR) is a prevalent cause of infertility among women in India. Doctors determine POR by conducting ovarian reserve tests. They categorize patients with low ovarian reserve as having poor ovarian reserve or borderline ovarian reserve.
Research indicates that Indian women experience accelerated aging of the available egg pool. Studies have revealed that ovarian reserve markers for Indian women, at a given age, are lower compared to their European counterparts.
Cost of ovarian reserve tests in Bangalore
AMH tests cost between INR 1000- 3500 in Bangalore. FSH test cost between INR 250-800 in Bangalore. Clinics and centers charge between INR 600-1800 for AFC tests.
Get tested at a reputable laboratory or center. Reliability of results is important.