How many eggs do I have?
The number of oocytes (ovules) a woman has peaked at approximately 8 million when she was a 20-week-old fetus. By the time a woman reaches puberty, there are approximately 500 oocytes left. Oocytes are lost every day in a process known as atresia. In some women, this process accelerates and especially with increasing age. Many times we are asked what is an ovarian reserve and what does it mean? As the number of oocytes decreases, the quality of the remaining eggs also decreases. Poor oocyte quality is characterized by reduced oocyte fertilization, subsequent embryo development, and embryo implantation. Age-related reductions in oocyte quality are also associated with an increase in chromosome abnormalities in embryos and oocytes. Man
What is an ovarian reserve and why is it important?
It is a qualitative term related to the ovarian response capacity to gonadotropin stimulation (FSH and LH) in women who have ovulation induction. Assessment of ovarian reserve is most often used by clinicians as a guide in selecting the gonadotropin dose used (Gonal-f / Follistim / Menopur) in IVF cycles.
Ovarian reserve has been evaluated using many methods over the years, including serum levels of follicle-stimulating hormone (FSH), antral follicle count, ovarian volume, serum FSH and estradiol levels of the menstrual cycle day 3 and the challenge test with clomiphene citrate. Perhaps the best test to assess ovarian reserve is by measuring serum antimullerian hormone (AMH) levels.
What does AMH mean for your fertility?
AMH is produced by the granulosa cells that surround each oocyte in the developing ovarian follicle. It is mainly produced by preantral and small antral follicles (less than 8 mm) in the ovary. Since these follicle numbers decrease with age, AMH production, and serum levels at any time reflect a woman’s ovarian reserve. AMH is not predictive of pregnancy, but it is predictive of a woman’s response to gonadotropin stimulation, the lower the AMH, the lower the ovarian reserve, and therefore the higher the dose of medication needed to try to achieve a mature oocyte at the time of IVF oocyte retrieval.