How to measure your ovarian reserve – what every woman needs to know ?

Many young women these days are choosing to postpone childbearing because they would like to pursue a career, but they also understand that this may come at the cost of their future fertility, because they know that as they get older, their ovarian reserve declines. This is why there is so much interest in testing ovarian reserve or ovarian function.

But there is still a lot of confusion. These are 4 things you need to know about testing ovarian function.

One is that we can do a simple blood test called the AMH level, which is a useful marker for ovarian reserve or egg quality, but it has its own limitations because it's just a number, and there is a lot of overlap between fertile patients as well as infertile patients. This is why you can't really jump to conclusions based on just one number.

This is where the second concept of trends comes in, which is why it is often helpful to plot serial AMH levels over a period of time because this gives you a better sense of whether your AMH levels are declining or not. If they are declining, then you may want to take action, whereas if they remain constant, you may be quite okay with postponing your childbearing decisions for the future. This is why it is often helpful for young women to start doing AMH levels on a routine basis every birthday after the age of 30 if they want to make sure that they are not compromising their future fertility. But please remember that it's not a good idea to jump to conclusions based on just one number, and therefore you need to take this advice with the understanding that it is not going to give you a 100% accurate picture.

So, along with doing the blood test as well as checking the trend over a period of time, it is also helpful to check a physical marker for ovarian reserve. This is a simple ultrasound scan that tests your antral follicle count, which gives us a good idea about what your ovarian reserve is likely to be. Again, this is a simple test and you can choose to do this on a yearly basis, so you can track what is happening just like you track your mutual fund returns or you track your bank account. This might be a useful biological marker for women to track.

But finally, remember that these tests all give indirect results and none of these are black or white, which means there is still a lot of uncertainty, and that the final proof of the pudding as far as your ovarian reserve goes is a dynamic test for ovarian function. The only test that really works today is achieving a pregnancy, which means if you get pregnant in your bedroom, then obviously your eggs are fine. The only other way of answering that question is by actually doing an IVF cycle to see whether your eggs are capable of becoming embryos. If they are, this obviously means that your egg quality is good enough. Obviously, this is a very expensive way of answering that question, but on the other hand, it also allows you to create embryos which you can then freeze as an insurance policy for the future.