How is the ovarian reserve evaluated?
The ovarian reserve indicates the woman’s reproductive potential in terms of the number of follicles she has. It is well established that the ovarian reserve diminishes with age. Women are born with around 400 000 follicles and several develop every month up until menopause when the ovarian reserve is depleted. When not achieving pregnancy, it is important to study the ovarian reserve especially if the woman is over 35.
Women are born with a finite number of eggs. When puberty is reached, various follicles mature in each menstrual cycle. Not all of these will be released however, as many are lost and only one egg becomes dominant and is ovulated.
To evaluate the ovarian reserve
To evaluate the ovarian reserve, there are different diagnostic tests. One of the most frequently prescribed tests is an ultrasound in the first days of the cycle (counting from when menstruation begins, between days 2 and 5) in which antral follicles are counted. The antral follicle is a small sphere filled with fluid containing an immature egg. A normal follicle count is when eight or more follicles are visualized by ultrasound. Although the follicular count varies every month, it is, along with the woman’s age and a hormone analysis on day three of the cycle, the most common tests used.
The hormone test evaluates the concentration of three important hormones: follicle stimulating hormone or follitropin (FSH), luteinizing hormone or lutropin (LH) and estradiol (E2). Levels over 10 mUI/ml indicate a low reserve. In fact, a woman in menopause has FSH levels can be 20 times higher than a woman with normal ovarian function.
In recent years an additional test to evaluate the ovarian reserve has been added to the ultrasound scan, the hormone test and the age of the woman. It is the evaluation of the Anti-Müllerian Hormone (AMH), a substance secreted by ovarian follicles. Its determination constitutes an important tool to assess the ovarian reserve.
The determination of AMH has several advantages in relation to other tests, since it can be performed any day of the menstrual cycle and is not accompanied by ultrasound (unlike the follicle count). An AMH below 0.8 ng/ml implies a low ovarian reserve regardless of the age of the woman.
Female fertility and age
Female fertility experiences a sharp decline at age 35, and from then on, it decreases by 15% each year, so at 40 it is quite difficult for most women to conceive with their own eggs. A study published in the journal Fertility and Sterility, shows a 25% chance of a 40-year-old woman getting pregnant with her own eggs. At the age of 43 years that percentage decreases to 10%, and to 1.6% by the age of 44 years. At the age of 45, it is almost impossible for a woman to get pregnant with their own eggs.
According to a Woom Fertility survey, almost 70% of Spanish women of childbearing age do not know what the ovarian reserve is and how it is evaluated. However, these tests are included in the basic fertility test we conduct at ProcreaTec for new patients. We are presently offering you this series of analytical tests at half their normal price.
Do not wait any longer and book your appointment!