Ovarian Reserve Tests

Ovarian Reserve Tests

Ovarian reserve is of major importance while planning for a pregnancy. Estimation of ovarian reserve is essential to predict the result and response of a procedure. Several tests exist that, directly or indirectly, estimate ovarian reserve. These tests are recommended for women with age over 35, who have failed to get pregnant within 6 months of trying to conceive, those who are planning to undergo IVF, people with PCOS, and for people who are planning to freeze their eggs. These include laboratory tests and ultrasound scan techniques. The most widely used tests are:

· Measurement of Anti-Mullerian Hormone (AMH) levels in the blood, which can be done at any time during the cycle.

· Measurement of Follicle stimulating hormone, Luteinizing hormone, and Estradiol on cycle Day 2-5.

· Transvaginal ultrasound measurement of the antral follicle count (AFC), ovarian volume

However, it remains unclear how useful any form of ovarian reserve testing is in predicting the chance of natural conception, the likelihood of pregnancy following fertility treatment, and the outcome of subsequent pregnancies.

These tests provide an estimate of a woman’s egg supply. Ovarian reserve tests mainly help in predicting the response to ovarian stimulation (low/poor response, high/excessive response, or cancellation of cycle): This is an important outcome from the perspective of determining treatment strategies, including the decision to not commence IVF. Thus, for example, if there is an increased chance of a low response then either IVF could not be commenced or different treatment strategies such as an increased dose of ovarian stimulation drugs used. Conversely, if there is an increased chance of a high response then lower doses of drugs or other strategies could be used.