- January 22, 2025
In addition to the age of the patient, the evaluation of the ovarian reserve is used to check the woman's reproductive potential. In this way the state of female fertility is examined, defined numerically as the number of egg cells in the ovary, which are capable of growth and development of the ovarian follicle. Different methods of evaluation of the ovarian reserve are used for these studies.
The most commonly used methods of evaluation of ovarian reserve are:
According to physicians, the most effective parameter allowing for the assessment of female fertility is the AMH hormone concentration test. It is a marker that precisely defines the ovarian reserve and the condition of the ovarian follicles. The hormone AMH is produced by the granular cells surrounding the egg cells, ready to grow in the growing preantral follicles. This test can be carried out on any day of the menstrual cycle because the concentration of the hormone AMH is independent of the stage of the cycle and remains relatively constant.
This test is carried out in a laboratory and consists of determining the hormone concentration in a sample of blood taken from a patient. Test results can be interpreted as follows:
When evaluating ovarian reserve, the FSH hormone content in blood serum is also determined. The examination should be carried out on the 2nd or 3rd day of the menstrual cycle.
Result above 15 mIU/ml indicates reduced or low ovarian reserve and has a negative effect:
It is difficult to determine clearly what is the threshold of the hormone FSH, which can be considered alarming. It is assumed that the concentration:
AFC is an examination of the number of antral bubbles carried out with the use of ultrasound apparatus. Antral follicles are found in the ovaries and have a diameter of 2 to 8 mm. They are ready for growth thanks to stimulation with natural gonadotropin, produced by the pituitary gland or hormones of the same nature, administered to a woman during infertility therapy. During growth in the natural cycle, one of the antral follicles becomes dominant and it is there that the egg cell matures.
The simplicity of AFC examination makes it possible for the doctor to quickly assess the condition of the ovaries. A result of less than 4 follicles in one ovary means a very low chance of getting pregnant and a lack of proper ovarian response to ovulation stimulation.
Every woman is born with a specific pool of egg cells in the ovaries, which mature at a later stage and become capable of fertilisation. During the menstrual cycle, some of these cells are used up and the ovarian reserve gradually decreases until the menopause occurs. After the age of 35, a woman's chances of becoming pregnant are usually significantly reduced, as the ovarian reserve is much lower and the quality of the solid egg cells is also deteriorating.
The evaluation of the ovarian reserve allows us to answer the question of how long the patient is likely to be pregnant without ovulation stimulation and whether this is possible at all. If the ovarian reserve is low, the use of assisted reproduction methods should be considered.
