Ovarian Reserve Tests

In addition to a woman’s age, a number of tests exist which, directly or indirectly, estimate ovarian reserve.

These include laboratory tests and ultrasound scan techniques. In particular,

  1. Measurement of Anti-Mullerian Hormone (AMH) levels in the blood, which can be done at any time during the cycle.
  2. Measurement of FSH, LH, Estradiol on cycle Day 2-5.
  3. 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 the subsequent pregnancies.

These 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.