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Ovarian Reserve Testing

Ovarian reserve testing: Know your numbers

Most women are aware of their cholesterol, blood pressure and weight. With the passing of years, you should add another number to your radar, ovarian reserve testing. This one measures anti-mullerian hormone (AMH). Texas Fertility Center in San Antonio includes this relatively new fertility test as a way for fertility specialists to assess ovarian reserve.

AMH testing estimates your egg supply now as well as your ability to produce eggs in the future.

In addition to your age, fertility specialists traditionally evaluate reproductive potential and ovarian reserve using three methods:

  1. Day 3 FSH blood testing to determine if the pituitary gland is sending hormonal signals to the ovaries to cause eggs to develop.
  2. Day 3 estradiol blood testing in conjunction with FSH testing to determine if the body is producing too much or too little estrogen.
  3. Transvaginal sonography to count the follicles developing in a monthly cycle.

Most progressive IVF centers also include AMH testing in the protocols, especially for women with signs of premature ovarian failure or advanced maternal age. The combined test results will give us an idea of the quantity (and to a lesser extent, the quality) of your ovarian reserve. Our physicians can then use this information to give you expert advice on the best course of treatment going forward.

How does AMH testing work?

Depending on your age and ovarian reserve, your ovaries contain between 10,000 and several million follicles, each holding an egg. These microscopic follicles also contain granulosa cells that release a chemical (AMH) that is detectable in the blood. When these immature follicles grow and develop beyond the pre-antral and small antral phase, they stop releasing this chemical.

In baseball terms, this “on deck” pool of microscopic follicles will decrease as a woman ages.

Interpreting AMH testing

Our partner reference labs measure and interpret AMH levels with a blood test. Results are given to your fertility specialist, who also analyzes the data in light of your history and plans for family building. A normal AMH range falls between 0.7 to 4.0 ng/ml, but you should expect your fertility specialist or OBGYN to allow for variations above and beyond these “cut-off” numbers.

  • If AMH levels are very low, you should consider taking proactive measures to preserve fertility, such as egg freezing.
  • If AMH levels are high, you may have polycystic ovarian syndrome, PCOS, a treatable condition associated with anovulation and other types of ovarian dysfunction.

Either way, AMH testing can lead to an actionable pregnancy plan. It’s a good number to know. Contact the fertility specialists at Texas Fertility Center – San Antonio to inquire about AMH testing.