Ovarian Reserve Testing

What is Ovarian Reserve Testing?

Normal ageing reduces a woman's capacity to become pregnant. Women's egg production declines as they age, their quality drops and the eggs' chromosomal (genetic material) abnormalities increase. Due to a combination of all these variables, older women experience higher rates of miscarriage and lower rates of conception.

All women experience a drop in their ability to conceive as they age, but the precise age at which they can no longer get pregnant differs from woman to woman. Some women experience this sooner than expected (at a younger age). When the female spouse is 35 years or older, around one-third of couples will experience difficulties getting pregnant.

Ovarian reserve testing (ORT) is a common and quick female fertility test indicating ovarian reserve, i.e., the number of eggs remaining in the ovaries for pregnancy. This test aids in evaluating the efficacy of the eggs following ovulation. In sum, ORT predicts the fertility potential of women.

Components of Ovarian Reserve Testing

An internal ultrasound scanning (vaginal) is employed for ORT, determining the follicle number on each ovary. Follicles are tiny fluid-filled sacs with the capacity for releasing eggs.

A frequent evaluation method for ovarian reserve is hormone blood level testing. Most patients undergo blood testing to assess specific hormones indicating fertility, such as estradiol, antral follicle count, and follicle-stimulating hormone (FSH) on the same day as an ORT. 

Estradiol and FSH levels are measured at the start of the menstrual cycle. The interaction between the pituitary and the ovaries can be inferred from these hormone levels. Although this testing can be performed on days one to five of the menstrual cycle, it is often conducted on day three of the menstrual cycle. 

Another ovarian reserve test is the antimüllerian hormone (AMH) testing. AMH is produced by the follicle and is associated with the number of eggs. Any point during the menstrual cycle is suitable for measuring AMH levels. The scanning and blood test results assist the consultant in determining the fertility level of the patient before treatment.

1. Why is the Ovarian Reserve Testing ordered?

ORT attempts to predict the response of a woman to fertility therapy and their egg production capacity. Importantly, it projects the likelihood of becoming pregnant relative to others in the same age category.

2. When is the Ovarian Reserve Testing ordered?

As it aids in understanding fertility, an ORT is typically one of the initial tests the consultant would advise during infertility treatment. An ORT must be performed between days one and five of the menstrual cycle to obtain accurate results.

3. How to prepare for the Ovarian Reserve Testing?

Tests involved in ORT could cause minimal discomfort and are non-invasive. There's no need for special preparation for ORT. Between days two and five of the menstrual cycle, tests for estradiol, antral follicle count, and FSH are usually performed. Any day of the menstrual cycle is suitable for checking AMH. Further, the patient can go directly home following the test.

4. How is the sample collected?

ORT comprises a vaginal ultrasound and simple blood work, which could be conducted at any time during the menstrual cycle. Results are usually available within a week. There are no adverse effects to ovarian testing. In the consultation, the Doctor will go over the test results and, depending on what they reveal, will guide the patient through their options for getting pregnant, including any suggested courses of fertility therapy.

5. What do the ORT results indicate?

Abnormal ORT findings indicate declined fertility potential, but they do not predict who will or will not become pregnant. Young women with normal ORT results could also have trouble getting pregnant. Although results may differ from cycle to cycle, any abnormal test often reveals a decline in fertility potential. The quality of the eggs has a significant impact on the likelihood of conception. A reduced chance of conception exists for women over 35 years with abnormal ORT results who have not received successful treatment. These women might be suitable candidates for donor eggs or embryos. Older women might have trouble getting pregnant even if their ORT results are normal. A woman's likelihood of becoming pregnant cannot be determined by a single ORT. The results of these tests are frequently utilised to create a treatment plan, which may call for using donor embryos or eggs. Making informed decisions about fertility and future family plans can be made easier with knowledge of ovarian reserve. It is encouraged to try to get pregnant sooner than anticipated or seek assistance from a fertility specialist if the ORT result is lower than anticipated. In addition, it is important to keep in mind that the normal levels and laboratory procedures differ from lab to lab. Hence, comparing results from various laboratories can be challenging.

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