Ovarian Reserve Testing, An Infertility Testing
A woman’s ability to conceive reduces as one gets older, especially in the mid to late 30s. As a woman gets older, the quality and quantity of eggs decrease, resulting in the possibility of infertility. To better understand the reason behind a couple’s infertility, infertility testing such as ovarian reserve testing is carried out. Ovarian reserve testing determines the number of remaining oocytes in a woman’s ovary.
Types of ovarian reserve testing
Ovarian reserve testing does not foresee the pregnancy outcome but helps to determine the response rate to fertility treatment. Ovarian reserve testing includes biochemical tests and ultrasound imaging. Biochemical tests include follicle-stimulating hormone, estradiol, and antimüllerian hormone and are done by measuring the hormone blood level. Clomiphene citrate challenge and gonadotropin tests are performed by injections. The antral follicle count is carried out by ultrasound.
Further details of the blood tests
The blood levels of follicle-stimulating hormone (FSH) and estradiol are drawn out at the beginning of the menstrual cycle. Normally, this is done between days 1 to 5 of the cycle but usually on day 3. If the level of FSH and/or estradiol is high, this means a decline in ovarian reserve. Antimüllerian hormone is checked during any period of the cycle and is considered to be a better test than FSH.
More on invasive procedures
The clomiphene citrate challenge test involves injecting clomiphene citrate during the early menstrual cycle, followed by checking the FSH level. Post-injection, a high level of FSH means reduced ovarian reserve. Gonadotropins injections are given to produce multiple eggs at once and the more doses given, the less likely to conceive. Antral follicle count is carried out by transvaginal ultrasound during the early phase of the menstrual cycle. The ultrasound method helps to count the number of antral follicles and indicates the number of eggs remaining.
The most precise one
Every type of ovarian reserve test has its limitations. However, the most accurate is the antimüllerian hormone test. Antimüllerian hormone test is more useful for women with higher chances of reduced ovarian reserve. The test is also preferable for those undergoing in vitro fertilization procedures.
Combination of ovarian reserve testing
A single ovarian reserve test may not always be reliable. Consequently, a study showed that combining ovarian reserve tests does not necessarily predict positive outcomes. There is also not much evidence about the success of applying the combination method. Nevertheless, ovarian reserve testing somehow helps a couple’s infertility concern by gaining a better biological understanding through tests.