Egg Quality And Female Infertility
A common misconception is that the only cause of female infertility is poor ovulation. But many underlying conditions can impact a woman’s ability to conceive. And an important factor could be poor egg quality. In the previous scenario, a woman may ovulate regularly, but the egg isn’t suitable for fertilization, which results in a failure to conceive. So, if a woman or fertility specialist suspects that poor egg quality may be the cause of infertility, what tests can be run to confirm the diagnosis?
Ovarian reserve testing
Ovarian reserve testing is a procedure in which a fertility specialist examines a woman’s ovaries. Often, a series of tests are conducted to create conclusive results. A common option is through blood tests that look for follicle-stimulating hormone (FSH), estradiol, and anti-müllerian hormone (AMH). FSH and estradiol are usually checked at the beginning of a woman’s menstrual cycle between days one and five, while AMH can be checked at any point during the cycle. Low levels of FSH and estradiol at the beginning of a menstrual cycle are normal, whereas higher levels may indicate an issue that causes poor egg development.
Clomiphene citrate challenge test
While some ovarian reserve tests solely focus on current hormone levels in women, other tests gauge the ovaries’ response to external stimulants. Sometimes, specialists may give a woman a medication known as clomiphene citrate. Afterward, blood is drawn to test a woman’s FSH and estradiol levels. Again, high levels of either hormone before or after the medication is administered can indicate an underlying problem with egg quality.
Gonadotropin response
For women who need fertility assistance, gonadotropin injections are a common option to help stimulate the ovaries and improve egg production ahead of undergoing various fertility therapies. A side effect is that the injections often trigger the growth of multiple eggs simultaneously. But a sign that a woman may have poor egg quality is if a fertility expert must administer higher doses. Often higher doses are associated with older women who are trying to conceive and tend to indicate that the woman is less likely to successfully conceive even when relying on a fertility therapy such as in vitro fertilization (IVF).
Antral follicle count
An antral follicle count is an exam that relies on a transvaginal ultrasound to visually count the total number of small follicles in an ovary. Small follicles are usually between 2-10 millimeters in size and are known as antral follicles. Each antral follicle serves as space for an egg to develop. While the test is best overseen by a fertility specialist, the exam can confirm how many eggs are available and if a woman’s ovaries are responding to gonadotropin medications.
Maintaining perspective with fertility tests
All of the above tests are designed to give a window into potential fertility issues. But higher hormonal levels or a lower antral follicle count don’t automatically mean that a woman can’t conceive. However, knowing about potential issues that can delay or make conception more difficult are important if a woman or couple wants to conceive. By knowing about underlying conditions, a fertility specialist can work with people to create a targeted plan that offers a higher chance of successful conception.
