- First of all what is ovarian reserve? Ovarian reserve is really a theoretical concept. All women are born with all the eggs that they will have for the rest of their reproductive life. As we age that reserve of good quality eggs that can result in a successful pregnancy will go down. Most infertility treatments are geared towards stimulating eggs for release or ovulation. However, if you don’t have any eggs to release, then these types of infertility treatments would not be beneficial for you. Therefore, the whole purpose of ovarian reserve testing is really to determine who will be a good candidate for infertility treatment.
- How is my ovarian reserve measured? There are several blood tests that can give your provider some insight into what your ovarian reserve might be. However, remember the numbers that these tests produce only mean something once your provider considers the results of other infertility testing, maternal age, and other factors. The most common test used today is AMH. Other tests include FSH levels and ultrasound screening to look at ovarian volume and antral follicle counts. AMH (antimullerian hormone) is secreted by a women’s eggs supply. As a woman ages and her egg supply declines, she will secrete less of this hormone which is used as an indicator of ovarian reserve.
- Does my ovarian reserve predict my fertility? I get this question a lot. So, my AMH is low- does this mean I will never get pregnant? The answer to this question is no. Several studies have shown that tests that estimate ovarian reserve fail to predict the short-term chances of getting pregnant. The same was true for FSH levels. Ovarian reserve tests should not be used to predict your ability to get pregnant as much as they should be used to determine which fertility treatments would be best for you.
- We find that patients have a lot of anxiety associated with their ovarian reserve and low AMH levels. Even if a young patient has a lower ovarian reserve relative to their age group, they can still have enough eggs to have a successful pregnancy. Ovarian reserve testing identifies patients that have a lower likelihood of conceiving without assistance. However, these tests are looking at averages and not the individual patient. I have had several patients with low scores for their age who have gone on to spontaneously conceive without any difficulty.
The bottom line is that some of these tests can help your doctor determine what type of treatment might benefit you as you seek pregnancy. Insight from these tests can help tailor individualized regimens to meet your specific needs. That being said, testing prior to even attempting pregnancy can lead to significant anxiety for some patients who may be able to conceive on their own. Generally, it would be suggested to try to conceive without assistance for 6-12 months, and then if needed, look to your physician for some advice. We’d be happy to help you figure out what might be causing your difficulties, if needed, and we’d be even happier to help you celebrate if you are successful on your own 😊
Dr. Pam
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