Ovarian Reserve and IVF: Do I Have Enough Eggs?
Besides a woman’s age, what are the top predictors of IVF success?
Ovarian reserve and body mass index (BMI) top the charts for IVF prediction. Both factors vary among women of all ages and together contribute approximately 20% to the overall picture of your chances of having a baby with IVF.
Your reserve may be discussed in the context of egg supply, which declines with age and can be measured indirectly through three clinical tests: 1) The level of the follicle stimulating hormone (FSH) on Day 3 of your menstrual cycle, 2) the number of “starter” antral follicles visible by ultrasound imaging of the ovaries at the beginning of your cycle, and 3) the level of the anti-mullerian hormone (AMH) in your blood.
Day 3 FSH
FSH is the primary follicle-stimulating hormone produced by the pituitary gland attached to your brain that drives the production of eggs in each menstrual cycle. In a healthy young woman, these levels are low on Day 3 and increase over the next week or two as follicles grow, producing progressively higher estrogen levels, which helps eggs to mature.
If your egg supply is low, your body still attempts to drive egg production by producing more FSH at an earlier time in the cycle. If FSH levels are higher than normal on Day 3 of the cycle, it is a good indication that ovarian reserve may be low.
In the first few days of your menstrual cycle, ultrasound imaging can detect a small group of “starter” or antral follicles visible on the ovaries. Those follicles are the pool of possible mature eggs for that cycle. A low antral follicle count at this point suggests that the total number of eggs in reserve is abnormally low.
AMH is produced by your ovarian follicles just before they are ready to start their final growing stage. AMH levels decline with age (Unlike Day 3 FSH, which rises as you get older). AMH blood tests can indicate the quantity of eggs remaining in the body, though they can’t be used to determine their quality, which also declines as ovaries age. Your AMH level does not change significantly from day-to-day of your cycle, so blood can be drawn at anytime. A low AMH level may mean that your ovarian reserve is also low.
Ovarian reserve is an important factor, but it alone cannot accurately determine your personal probability of getting pregnant with IVF. For example, your ovarian reserve may be above average for your age, but other fertility factors (body mass index, male factor, and others) could result in a lower probability of pregnancy. On the other hand, you may have a strong probability of success with IVF even if you have a low ovarian reserve due to good results in other fertility factors.
The Univfy PreIVF® Report™ is the only personalized report that uses all your health data and the outcome data of your IVF clinic to give you a more accurate prediction of success per cycle.
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The contents of this blog are for informational purposes only. Content in this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Reliance on any information provided by Univfy, Univfy employees, or others appearing in this blog or on the Univfy website is solely at your own risk.
About the Author:
Mylene Yao, M.D. | Co-Founder and CEO of Univfy
Dr. Mylene Yao is a board-certified OB/GYN with more than 20 years of experience in clinical and reproductive medicine research. Prior to founding Univfy, she was on the faculty at Stanford University, where she led NIH-funded fertility and embryo genetics research and developed The Univfy Platform with the academic founding team. See her full bio here.