TESTS FOR
OVARIAN RESERVE OF OOCYTES (EGGS)
Testing for
the reserve of oocytes (eggs) in the ovaries is a key part of fertility
investigations. The test result can dictate and direct the type of treatment
required and the urgency with which treatment should be conducted.
A woman is born with a set number of eggs in her ovaries to last the woman’s reproductive lifespan. As the years go by, the number of eggs in the ovaries decline in quantity and quality. This is the reason for the decline in a woman’s fecundity with increasing age. Menopause occurs when there is depletion of eggs in the ovaries.
A woman is born with a set number of eggs in her ovaries to last the woman’s reproductive lifespan. As the years go by, the number of eggs in the ovaries decline in quantity and quality. This is the reason for the decline in a woman’s fecundity with increasing age. Menopause occurs when there is depletion of eggs in the ovaries.
Tests include:
The test has to be done in the early follicular
phase i.e. on days 2 to 5 of menstrual cycle. A high FSH level indicates low
ovarian reserve. A very high result indicates depletion of eggs and may
indicate the menopause.
AMH measurement is at present the best test to
assess ovarian reserve. Unlike FSH test, AMH blood test can be done at any time
of the menstrual cycle. A low AMH concentration indicates low ovarian reserve.
AFC is assessed by ultrasound scan in the early
follicular phase pretty much like FSH blood test. A low AFC count indicates low
ovarian reserve.
Ovulation induction and indeed assisted conception treatments are less likely to be successful in women with low ovarian reserve. At present there is no proven effective treatment to boost egg production (quantity and quality) in women with low reserve. The use of androgens, in particular DHEA tablets, is recommended by some practitioners but it remains controversial, there are no large enough studies to confirm its effectiveness. For most women with very low ovarian reserve, the use of donor eggs provides the best option for a successful treatment outcome.
J. Adeghe
Consultant – Gynaecology & Reproductive
Medicine
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