By: Erica Keller – Kindbody Physician Assistant (San Fransisco)
So you’ve completed your first Fertility Assessment appointment with Kindbody and you’ve been reassured that your ovarian reserve looks normal for your age…now what? Trend it yearly!
First and foremost, what is ovarian reserve testing?
Ovarian reserve testing is evaluated at your Fertility Assessment through a simple blood test for anti-mullerian hormone (AMH) and a pelvic ultrasound for your antral follicle count (AFC). The AMH level and AFC together help your provider predict your current ovarian reserve, aka the general size of your remaining egg supply.
Why do we care about ovarian reserve levels?
According to research, AMH levels can help your provider predict how good of a candidate you are for fertility treatments like in vitro fertilization (IVF). The lower one’s AMH, the less responsive her ovaries tend to be during stimulation treatments used in IVF; less responsive ovaries means fewer eggs are retrieved during each IVF stimulation cycle, and subsequently, fewer embryos will be formed.
How quickly does one deplete their ovarian reserve?
Generally speaking, AMH and AFC decrease with increasing female age. There are no physical symptoms for declining egg count, and up to twenty percent of biological women under the age of 35 will have a premature decline in ovarian reserve. Further, there are many factors that can accelerate this rate of decline, such as endometriosis and smoking tobacco. Long story short: while egg count generally decreases with age, there is no easy way to truly predict how quickly each individual patient’s ovarian reserve will decline with each passing year.
Goal of yearly testing:
By testing your ovarian reserve yearly, we are able to keep an eye on the general decline in your AFC and AMH levels for you. As stated above, while we generally know that ovarian reserve declines with age, we can’t predict your individual rate of decline. Therefore, yearly assessments allow us to:
- Monitor your candidacy for infertility treatments, and discuss options available to you as early as possible
- Screen you for other gynecologic conditions that can affect your fertility such as endometriosis, ovarian cysts, uterine polyps, and fibroids, by nature of the ultrasound portion of the assessment. This can help with early treatment interventions and/or symptomatic management as needed
- Help you with your family planning in real time.
- Please keep in mind that ovarian reserve testing simply tests for your ovarian reserve aka the number of eggs you have, and indirectly, how good of a candidate you are for treatments like IVF in terms of the number of eggs that we can retrieve. It does NOT speak to one’s ability to conceive or form genetically normal embryos, which is dependent on many other factors, such as your age.
- Think of routine ovarian reserve testing as regular check-ins to see if you need to do something about your fertility NOW.
- We always recommend considering preservation (egg or embryo freezing) at the youngest age possible regardless of your egg count, for better fertility outcomes in the future. Your Kindbody provider can help personalize this recommendation further with regular assessments and conversations.
At Kindbody, we believe that knowledge is power, and routine ovarian reserve testing is part of that. We look forward to helping you trend this number over the years!