3 Ways to Find Out If You Have Low Ovarian Reserve

If you’re having trouble getting pregnant, low ovarian reserve may be a factor.

At IVFMD, our team of board-certified fertility specialists help women at our offices in Arlington, Irving, and Grapevine, Texas, get to the bottom of their fertility challenges and realize their dreams of having a baby.

Here, we take a closer look at the issue of diminished ovarian reserve — how to verify it and how we address it.

How many eggs is enough?

When you were in your mother’s womb, you had in the neighborhood of 6-7 million eggs, but they didn’t all survive. By the time you entered the world, you only had about 1-2 million eggs. During childhood, your supply waned yet again, and when you hit puberty, you had approximately 300,000 eggs.

Each menstrual cycle further depletes your supply, so as you age, you have fewer eggs to work with, which can affect fertility.

What is egg quality?

Your eggs come with an expiration date. The longer you wait to use them, the higher the chances they’ll exceed their shelf life.

When your eggs are in reserve, they’re dormant and immature. They begin the maturation process when your hormones call one or more of them to duty during ovulation. At this point, their cells divide and multiply.

If your eggs are old, they’re prone to errors during this maturation process. The DNA within malfunctions, and the result is either an unfertilized egg, a fertilized egg that ends in miscarriage, or a baby with a genetic disorder, such as Down syndrome.

All women have at least some abnormal eggs, but if you wait to start your family until age 35 or later, you have fewer eggs in reserve, and a higher percentage of them are of poor quality.

How to tell if your ovarian reserve is diminished

A low ovarian reserve isn’t obvious. In fact, the only symptoms — difficulty getting pregnant, heavy periods, and miscarriages — are also common signs of other conditions, so you can’t rely on them alone to tell if your egg supply is low.

If you experience these symptoms and you have one or more of the risk factors for low ovarian reserve, there’s a good chance your eggs have diminished in quality and quantity. In addition to age, the risk factors include:

• Genetic mutations that affect your ovarian function
• Ovarian surgery
• Chemotherapy and/or radiation
• Endometriosis

But symptoms and risk factors aren’t definitive. To verify low ovarian reserve, we run ovarian reserve diagnostic tests to give us more accurate information.

Basal follicle stimulating hormone (FSH) test

FSH is the hormone that calls your eggs into action and begins the follicle’s maturation process. Your FSH naturally fluctuates throughout your menstrual cycle, but when your egg reserve is low, your pituitary gland amps up the production of FSH to coax the eggs into service.

For this reason, a spike in your FSH level is a good indicator of low egg reserve.

The FSH test isn’t optimal because it must be measured during the first three days of your menstrual cycle, and high FSH levels indicate that your egg reserve has already diminished considerably, so it’s a late sign. This means treatments may be less effective.

Anti-mullerian hormone (AMH) test

A simple blood draw at any point in your menstrual cycle gives us valuable information about other hormones in your body. In particular, we test for anti-mullerian hormone produced by immature, small ovarian follicles.

If your AMH level is 1.5 ng/ml or higher, your egg supply is normal. But if it dips below that level, you have a lower-than-normal egg quantity.

Basal antral follicle count (AFC) count

If you’re wondering if there’s a simple way to count your eggs, you’re onto something. The AFC test gives us a visual assessment so we can count the eggs in your ovaries at the beginning of your cycle.

Using transvaginal ultrasound technology, we can see and count the number of eggs in your ovaries. If you have 12 or more, it’s considered normal, but lower than that means your reserve is low.

How we address low ovarian reserve

Depending on how low your egg reserve is, there are several ways we can help you become pregnant, including:

• Aggressive IVF protocols
• Mini IVF
• Ovulation induction
• Intrauterine insemination
• Donor egg IVF

To check your ovarian reserve, schedule an appointment at any of our three locations in the Dallas-Fort Worth area by calling our friendly staff or booking online.