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Ovarian Reserve Test

After listening to 5 most common reasons for infertility and understanding that age beyond 30 is one of them, Mrs TJ who just turned 30, got curious to know more about the ovarian reserve.

Of course, her next question was how to assess the ovarian reserve!

I went on explaining that females at birth have around 2 million eggs. By the time they reach puberty only 2 lakh eggs are left. Of these only 300-400 ovulate and almost a 1000 immature eggs are lost every month.

The term “Ovarian Reserve” is an indicator of the remaining eggs in a woman that will fertilise and produce babies. The ovarian reserve tests are a part of the initial assessment of the women presenting to clinic with infertility.

The ovarian reserve of a woman tends to decrease with her age. These tests have become increasingly popular with the growing trend of having babies after 30 years of age. Older eggs are more prone to errors in division. Hence increased risk of Down’s syndrome in woman over 35. With increasing age, the ability of the ovaries to produce quality eggs and follicles declines.

Following are the most common ways of testing the ovarian reserve:

1. Anti-Mullerian Hormone AMH Test –

  • What is it? This is a blood test for the hormone released from the tint follicles in the ovary. Therefore, AMH hormone level is a good indicator of the number of follicles present in the woman. A higher level of the Anti-Mullerian hormone signals towards the presence of a large number of follicles and immature eggs that can be easily fertilised to achieve pregnancy.
  • When is it done? This test can be performed at any time of the periods.
  • How long does it take for the results? Reports are usually made available in 24 hours

2. Antral Follicle Count AFC

  •  What is it?  AFC is number follicles present in the ovary. These are small (antral) follicles ranging between 2mm to 6mm in diameter, counted using pelvic ultrasound scan. The number of antral follicles present in the women is an indication of the number of immature eggs that are ready to be fertilised in the future. This number is dynamic and changes every month based on how many follicles are recruited.
  • When is it done?  This is performed on second or the third day of the menstrual cycle.
  • How long does it take for the results? Reports are usually made available in 24 hours.

3. Follicular Stimulating Hormone (FSH)

  • What is it? This is a blood test carried out to measure FSH hormone level. FSH is produced in the brain and stimulates the ovary to make good follicles growing to release good eggs.
  • When is it done?  Second to fifth day of the periods, it should be a fasting blood sample.
  • How long does it take for the results?  Reports are usually made available in 24 hours.

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