Is Ovarian Reserve an Indicator of Pregnancy Success?

Infertility is a functional diagnosis. That means the only way one can be diagnosed as infertile is if they don’t get pregnant after 12 months of trying. It makes complete sense that there’s a lot of appeal to the idea of a fertility test. Wouldn’t it be amazing to know your chances of getting pregnant before you even you start trying? This could help you plan better by allowing you to jump straight to your required fertility treatments or allow you to consider the option of freezing your eggs earlier. These types of pregnancy or fertility tests are formally known as ovarian reserve tests.

Research shows and most reproductive endocrinologists understand ovarian reserve tests are important. However, they are also aware of the fact that these tests cannot accurately predict your chance of getting pregnant. That’s because they can only tell one side of the story.

What is Ovarian Reserve Testing?

Ovarian reserve is just another word for egg count. Testing usually takes the form of an anti-Mullerian hormone (AMH) blood test and an antral follicle count.It is the cells of ovarian follicles that produces the Anti-Mullerian Hormone and it is a protein hormone.

Reproductive endocrinologists can estimate the number of follicles inside your ovaries by looking at the AMH level in your blood. On the contrary, your physician performs antral follicle count during an ultrasound. The doctor can count the activated follicles, and then use that number to predict a woman’s total ovarian reserve. 

Testing Follicle-Stimulating Hormone (FSH) Level

There’s also an older method for measuring ovarian reserve, but it’s less accurate for pregnancy test than the above-mentioned methods. This method includes Follicle-stimulating hormone (FSH), estradiol, and inhibin testing on the third day of a menstrual period.

FSH is a chemical that helps the follicles to mature and release an egg. So, a high level of FSH indicates that the ovarian reserve is low.According to many medical professionals and fertility advocates, these test results are critically important.

A study was conducted with over 750 women attempting to get pregnant. The results of this study showed that women with low anti-Mullerian hormone levels (0.7ng/ml and lower) or high follicle-stimulating hormone levels (10 mIU/mL or more) have a significant lower chance of getting pregnant as compared to women with typical hormone levels.

Egg Count vs Egg Quality

These ovarian reserve tests tell us about a woman’s egg count which is only one factor of fertility and pregnancy success. However, there is another more important factor which indicates whether a woman can get pregnant, stay pregnant, and deliver a healthy baby – Egg Quality.

Egg quality indicates whether an egg is genetically normal or abnormal. Abnormal eggs will most likely lead to miscarriage or genetic disorders in the child.Abnormal eggs are directly related to a woman’s age. Younger women will mostly have normal eggs, while older women will mostly have abnormal eggs.

This clearly implies that the decline in natural fertility with increasing age is actually a result of diminishing egg quality and not necessarily the egg count.

Egg quality is not dependent on either AMH or FSH levels. It is because a woman will naturally ovulate one egg per month. So, the chance of a natural pregnancy depends exclusively on egg quality and not the number of eggs. 

Is It Possible To Know Egg-quality Beforehand?

To put it in simple words, there’s NO test that can one can avail to determine the quality of the eggs in advance. One can perform tests to look for genetic abnormalities only on embryos. Although, it is only possible after they are fertilized and developed to blastocyst stage, not on the eggs themselves. 

However, there’s well-supported scientific literature about age factor. It indicates a direct relationship between a woman’s age and the number of normal embryos that can be created from her eggs. This relationship is useful for doctors to estimate the number of healthy eggs. It can also calculate chances of ovulating a healthy egg in any given month by just accessing her age.

What Ovarian Reserve Testing Can’t Tell Us?

Ovarian reserve testing cannot show us the quality of the remaining eggs. Also, egg count alone is not enough to estimate a woman’s chance of getting pregnant.

Even if a woman has plenty of eggs left at the age of 42, it is likely that 75% of them are abnormal. This means she is going to have a difficult time getting pregnant. While on the other hand if a younger woman, at the age of 25 has around 75% genetically healthy eggs but her ovarian reserve is running low, she still has a high chance of achieving pregnancy. That’s the reason why experts recommend egg freezing before age 35.

What Ovarian Reserve Testing Can Tell Us?

Ovarian reserve testing is significant for pregnancy success as it has very important uses in fertility medicine. These tests can show when a woman is getting close to menopause. A sustained high FSH level in your blood is used to confirm menopause. In the meanwhile, AMH levels are strongly tied to time until menopause. 

AMH count also indicates other potential reproductive issues, such as polycystic ovarian syndrome (PCOS). It is a condition where a woman’s ovaries develop many follicles but don’t release an egg. This is because of an abnormally high AMH level.

Egg-Count And IVF

Additionally, a woman’s egg count directly affects the chances of success with In Vitro Fertilization (IVF). That’s because IVF success rates are tied to the number of eggs doctors can retrieve in any given cycle. Women with a higher ovarian reserve have a more positive response to hormone medication used during the fertility treatments. This produces more eggs in a single cycle.

For example, if a woman’s egg freezing cycle produces 15 eggs, 80-90% of them are likely to be mature. Also, about 90% of the eggs will survive the thawing process, leaving approximately 12 eggs. The percentage of those eggs that will produce an embryo healthy enough for a pregnancy depends on the woman’s age at the time of freezing.

However, the number of eggs she has to work with is higher in comparison to a woman with a lower ovarian reserve (they may only produce 7 or 8 eggs). 

Conclusion

Ovarian reserve is a vital part of the overall picture of your fertility health. Your current age and medical history are important factors in determining your chances to get pregnant. Coastal Fertility in Orange County, CA has a team of experts that can help you take these tests. We can help analyze your fertility in no time. Visit us at coastalfertiltiy.com to learn more about ovarian reserve tests and successful pregnancy or call us at 949-726-0600.