Ovarian reserve testing is an important process in successful fertility treatment. Dr Anna Carby explains exactly what this is.
What is ovarian reserve testing?
“You will frequently see this term referred to in fertility clinics. This is the capacity for your ovaries to respond to stimulatory drugs and is generally measured with hormonal testing (particularly AMH – anti-Mullerian hormone testing) and an internal ultrasound scan looking at the ovaries and specifically the number of small follicles in each ovary – known as antral follicles.
“In general, the higher the AMH and the total number of antral follicles, the higher the expectation that the ovaries could respond to stimulation.”
What does this tell me about my natural fertility?
Dr Carby points out that “your ovarian reserve has little bearing on your ability to conceive naturally and cannot be used as a marker of this. Generally, the tests performed for egg freezing do not tell us anything about whether your tubes (fallopian tubes) are open or damaged. Ovarian reserve testing is only used as a marker of response in assisted conception treatments such as IVF and egg freezing.”
Does anything change my ovarian reserve?
There are a few elements that can change your ovarian reserve, as Dr Carby reveals: “Ovarian reserve will get lower with age – this is a natural biological process. In addition to this, smoking is known to affect ovarian reserve. Whilst it is possible to undergo egg freezing if you smoke the outcome you may gain from treatment may not be as good.
“In addition, some contraceptives such as the Pill and some coils such as the Mirena coil can lower ovarian reserve. Depending upon how urgent egg freezing is it may be sensible to repeat ovarian reserve testing a few months after stopping or removing devices. Some studies suggest an up to a 20% decrease in ovarian reserve with contraceptives. Currently, there are no medications known which can improve ovarian reserve.”