Ovarian Reserve Testing

An assessment of the eggs inside the ovaries is an important part of a fertility evaluation. Women are born with all of the eggs they will ever have and lose these eggs slowly over time. At birth, the ovaries contain several million eggs, at the onset of puberty there are approximately 200,000-400,000 eggs, and by the time menopause occurs, it is more like 1,000. The number of eggs present depends largely on age, but can vary widely from person to person.  

The purpose of ovarian reserve testing is to estimate the number of eggs present. This information can be used to determine which type of fertility treatment is most appropriate and to predict the response of the ovaries to fertility medications.

Ovarian reserve testing includes:

• An ultrasound to determine the antral follicle count. A follicle is simply an egg surrounded by supporting cells. Antral follicles are eggs in their latest stages of development, and are visible on ultrasound as small dark circles within the ovary
• A blood test for anti-Mullerian hormone or AMH. AMH is a hormone produced by antral follicles, and by smaller follicles that are not yet visible on ultrasound
• A blood test for follicle stimulation hormone or FSH. FSH is less predictive of ovarian response to fertility medications but can be useful in situations where the egg count is low

It is important to note that while ovarian reserve testing gives us information about the quantity of eggs, it does not tell us about the quality of eggs. Egg quality refers to the ability of an egg to create a viable embryo and pregnancy. This is something that is determined primarily by age, and is NOT related to the number of eggs. There is no “test” for egg quality. Your doctor will discuss this with you in detail at your first appointment at UCSF CRH.