Ovarian Reserve – a Vital Sign Every Woman Should Check
When we think of vitals signs, we imagine the 4 tests that tell us that everything’s ok – body temperature, pulse rate, breathing and blood pressure. If everything’s normal, we can assume we’re healthy, right?
But if you’re a woman between 20 and 30, there’s one vital sign that is often overlooked and that’s
ovarian reserve. While fertility may not be at the top of your list of priorities when you’re young and taking on the world, we at Marin Fertility believe that knowing your ovarian reserve is essential to a preserving your fertility future. Even if having children isn’t part of your grand plan, your ovarian reserve can tell you a lot about your reproductive health.
At its simplest ovarian reserve is an estimate of the number and quality of eggs remaining in the ovaries. Ovarian reserve decreases with age. We’re born with about a million eggs and by the time a girl reaches puberty, that number is down to 400,000. By the age of 35, the number of eggs starts to decrease sharply and, past the age of 40, becoming pregnant can be very difficult.
There are three things that can give some indication of your ovarian reserve: Anti-Mullerian Hormone or AMH, Follicle Stimulating Hormone or FSH, and your Antral Follicle count or AFC.
AMH can be measured with a simple blood test at any time during your cycle and gives you an indication of the number of eggs you may have. The developing ovarian follicles produce this hormone so the higher the number, the greater the number of healthy egg cells. An AMH that’s too high can also be an indication of polycystic ovarian syndrome or PCOS.
But AMH doesn’t give the whole picture. For a better idea of your ovarian reserve, you would have two tests on day three of your cycle – the FSH or Follicle Stimulating Hormone and estradiol which is the main form of estrogen in your body. FSH is released by the pituitary gland to stimulate the follicles on the ovaries to produce an egg. As ovarian function slows down, more FSH needs to be released to prompt the remaining follicles to grow. As we age, it takes more effort for the ovaries to release an egg. An elevated FSH level is a possible indication that the ovarian reserve is diminished.
A transvaginal ultrasound can be used to determine how many ovarian follicles are growing. This is called the Antral Follicle Count or AFC. Too few follicles are an indication of diminished ovarian reserve, while more than 12 per ovary may indicate Polycystic Ovarian Syndrome.
So what happens if one, or all, of these tests come out ‘bad’? Ideally, you want your FSH to be low, your AMH and AFC to be high. We’re here to help you understand what the numbers mean and how you can take action. At Marin Fertility Center, we believe that knowledge is power. We offer a complete ovarian reserve assessment at all of our offices.