Ovarian receive test or egg reserve testing is an infertility testing method where a women’s ovarian reserve is examined to evaluate the amount and quality of eggs typical of a women’s age. It is a standard process of infertility treatment.
A woman is born with upwards of 1 million oocytes (eggs), which gradually decreases with time and age as the number of antral follicles decreases with age, which causes a decrease in serum Anti-Mullerian Hormone (AMH). It is estimated that a woman may typically lose around 10–30 eggs every day throughout a menstrual cycle. On the other side, during mid-thirties until menopause, egg fertility steadily decreases, leaving the ovarian reserve with only 100–500 eggs per ovary.
Additionally, the quality of the eggs in the ovarian reserve is different. In actuality, only a small percentage of oocytes in ovaries may lead to pregnancy. Few of those who are genetically normal will either die in the embryonic phase or fail to mate with sperm. Ovarian reserve testing helps in figuring out the possible aberrant causes for this decline.
Other variables that might impact fertility include erratic ovulation and abrupt changes in hormone levels. The measurements of these hormones serve as the basis for several ovarian count tests and follicle count tests for normal ovulation.
Getting pregnant in the late thirties or beyond that age is difficult and the problem becomes more complicated if the person has had some ovarian surgery. An ovarian reserve testing can help in determining the number of remaining oocytes and the possibility of conceiving. Age, Follicle Stimulating Hormone (FSH), Antral Follicle Count (AFC), and Anti-Mullerian Hormone are some of the factors impacting the fertility egg count that may be examined to choose the appropriate test for ovarian reserve (AMH). The early stages of the ovulation cycle, before the full flow, are when this egg reserve test is performed.
Factors Affecting Ovarian Reserve
As women are born with a sufficient number of eggs at birth and this gradually decreases with age. According to the American College of Obstetricians and Gynecologists, the average number of oocytes present in a woman’s ovaries from the gestation phase to menopause is estimated to be around:
While the gradual decrease is a natural process, quicker depletion of ovarian reserve is often caused by various internal and external factors. Some factors contributing to the depletion of ovarian reserve are:
Age
Age of a woman is probably the most crucial element in determining the likelihood of a safe pregnancy among women. The present tendency among young women to have children late in their life has emerged as an alarming issue for decreasing fertility rate in Nepal. As fertility is anticipated to fall gradually with age and number and quality of eggs significantly decline beyond the age of forty.
However, this is not always the case; some couples struggle with infertility for reasons other than age. Despite the introduction of advanced infertility therapies, women must still undergo an ovarian egg count test to identify the key barrier to success.
Anti-Mullerian Hormone Test (AMH Test)
AMH (anti-Mullerian hormone) is an important hormone for a woman throughout her reproductive years to determine the number of remaining eggs. As AMH is released by follicles, testing a woman's ovarian reserve for AMH provides a big help in future treatment. AMH doesn't change throughout the monthly flow thus the blood test for fertile eggs can be performed at any point during the month. However, women on birth control are not recommended anti-Mullerian hormone tests.
The AMH level assesses a woman's current reproductive status. According to studies, the anti-mullerian hormone ovarian test confirms the viability of the ovarian egg reserve and the chance of conception. AMH decreases throughout the childbearing years and disappears after menopause. Typically, the outcome of AMH is focused on a condition where the polycystic ovarian syndrome(PCOS) is becoming more prevalent.
Who are eligible for Anti-Mullerian Hormone test?
Women who are interested in learning more about their ovarian reserve screening for upcoming family planning.
Female trying to get pregnant for at least six months and looking to know the present condition of ovarian reserve in accordance to her age.
Women seeking IVF or other fertility testing. The AMH level, together with the Antral Follicle Count (AFC) and Pelvic Morphology Scan, is thought to be a reliable indicator of IVF success.
Women who wish to know if they were successful in conceiving after undergoing aggressive chemotherapy or ovarian surgery.
Understanding the Anti-Mullerian Hormones (AMH) test result
Anti-Mullerian Hormones test is usually carried out during the first phase of the ovulation cycle, where blood samples are collected to measure the AMH level. The evaluation's supplied report shows if the AMH level is Normal, Low, or Raised.
| AMH Level mg/ml | Interpretation | Expected Response to FSH | Cancellation rate with IVF |
Pregnancy rate with IVF |
| >3.0 | High, often PCOS | High | Low | Normal |
| 1.0-3.0 | Normal | Fair | Low | Normal |
| 0.4-0.9 | Low | Low | High | Low |
| <0.4 | Very Low | Extreme low | Very High | Extreme low |
Who can take the Day 3 Follicle-Stimulating Hormone test (FSH)?
Follicle-stimulating hormones are hormones released by pituitary glands that play a huge role in the functioning of the menstrual cycle.
Increased levels of FSH signal the ovaries to produce more estradiol (estrogen) during the first part of the menstrual cycle while also recruiting and triggering an egg in the ovary to develop for ovulation. FSH is commonly tested on days 3–4 of a normal cycle because this provides a solid baseline level for FSH before it starts rising quickly during the ovulatory phase of the menstrual cycle.
Day 3 FSH Test for women
Day 3 Follicle-stimulating hormone test is carried on the third day of the cycle to get an indication of ovarian reserve. The FSH test can help assess the cause of:
Day 3 FSH Test for Men
Day 3 FSH test in men is conducted to:
Understanding the test result of Day 3 Follicle Stimulating Hormone (FSH)
| Day 3 Follicle-Stimulating Hormone (FSH) | Interpretation |
| Less than 20 | Extreme low FSH. No response to stimulation. |
| 16-20 |
Low FSH. Reduction in embryo qualitylow response to stimulation, with a low birth chance. |
| 13-15 | Reduced FSH. Fair response to stimulation and embryo quality with IVF. Fair chances of pregnancy. |
| 10-12 | Normal FSH. Response to stimulation is slightly reduced, while there are normal chances of pregnancy. |
| <10 | Above normal FSH and ovarian reserve stimulation is good with high chances of pregnancy. |
A decrease in the generation of fertile eggs is indicated by the elevated FSH result. Women's fertility begins to drop as they become older. The luteinizing hormone, progesterone, and estradiol levels, as well as any additional related values, may all be determined with the FSH test.
A high FSH level indicates fewer pregnancy chances than anticipated for the projected age.
High FSH levels in males are a sign of testicular injury or absence brought on by heavy drinking or radiation therapy.
Low FSH levels indicate low-quality egg production in women and low sperm counts in males.
Antral Fossile Count (AFC)
Antral follicles are tiny follicles that may be seen, measured, and counted using ultrasonography. They range in size from 2 to 9 mm and are also known as Resting follicles. Antral follicles are responsible for the higher production Anti-Mullerian Hormone (AMH), which circulates in the blood.
Antral Fossicle count is a test conducted to determine the number of eggs or the condition of the ovarian reserve. Transvaginal ultrasonography is used, and fertility specialists are present to count the number of egg-containing follicles in both ovaries. AFC is currently recognized as a reliable indicator for determining the functional ovarian reserve and predicting the outcome of gonadotropin stimulation during IVF.
Antral Follicle Count Test: Who is it for?
Antral follicle count test or egg reserve test is conducted between the cycle days 2 and 5. This is done via transvaginal ultrasound. The number of follicles in each ovary will be continuously monitored by the ultrasound technician. 8 to 15 follicles are regarded as an ideal number for IVF therapy. IVF specialists may recommend antral follicle count to individuals if they need to evaluate:
What Antral Follicle Count test looks like?
| Antral Follicle Count | Interpretation | Expected Response to FSH | Anticipated Cancellation with IVF | Anticipated Pregnancy with IVF |
| <4 | Extreme Low | Extreme Poor | Extreme High | Extreme Low |
| 4-6 | Low | Poor | High | Low |
| 7-10 | Reduced | Reduced | Increased | Decreased |
| 11-30 | Normal | Good | Low | Excellent |
| >30 | Good | High Risk of Hyperstimulation | Low | Fair |
If you are looking for a confidential as well as trusted fertility center for Ovarian Reserve Testing or any services related to fertility, you don’t have to look far from Nepal IVF. Nepal IVF and its team of fertility specialists have more than 20 years of experience treating male infertility. Contact or visit Nepal IVF today for cost-effective fertility treatment.
