3 tests can help determine if you have low ovarian reserve2
In women over 35, low ovarian reserve is common. A decrease in the ovarian reserve means there are fewer eggs to grow and mature, and therefore fertility may decrease.
Women are born with a certain number of eggs. Unlike men, who continue to make sperm throughout most of their lives, women are unable to make more eggs than what they are born with.
Smokers, women with a family history of premature menopause, and women with autoimmune diseases may all be at risk of premature menopause.
There are three tests currently available to measure the ovarian reserve.
1. An ultrasound, done at the beginning of a menstrual cycle that counts the preantral follicles in the ovary. A number greater than five is a good prognostic for reserve.
2. A blood test for the level of FSH, or follicle-stimulating hormone, when estrogen level is at the lowest, usually on day 2 or 3 of a cycle. Lower estrogen means a higher FSH level is needed to stimulate the follicles and enable the egg inside each follicle to grow and mature. A low ovarian reserve also means more FSH is needed to stimulate egg maturation. A high FSH level, over 15, is a poor prognostic sign for ovarian reserve, indicating a low reserve.
3. Test the level of AMH, or antimullerian hormone, a hormone produced by the ovarian follicles. This blood test can be done on any day of a menstrual cycle. A low AMH level is a poor prognostic sign indicating low ovarian reserve.
Unfortunately, science cannot make more eggs, or predict what will happen to women as they age. Experts insist that women in their 20s should be encouraged to have at least one test of ovarian reserve if they are considering having a family in the future.
A diminished ovarian reserve is not the end of the world, and in the case of infertility, there are affordable fertility treatments, like low cost IVF, to help women achieve pregnancy.