Ovarian reserve also can be called egg count, which typically includes an anti-Mullerian hormone, Blood test, and an antral follicle count. AMH is the protein hormone produced by cells inside the ovarian follicles, and the level of AMH in the blood can help the doctor to determine the number of follicles inside the ovaries. An antral follicle, on the other hand, is performed by the doctor during the ultrasound. After visualizing the ovaries the doctor can count the activated follicles and use that number to estimate the woman’s total ovarian reserve.

The ovarian reserve tests tell us about a woman’s egg count, which is one-factor infertility. The other factor that whether a woman can get pregnant, stay pregnant and deliver a healthy baby is egg quality. Egg quality generally refers to egg that is genetically normal or abnormal, as abnormal eggs will lead to infertility, miscarriage or genetic disorder such as Down syndrome.

The doctor explains the decline in natural fertility with age is actually driven primarily by egg quality. Regardless of a woman’s egg count whether AMH and FSH levels are low or high, she naturally ovulates one egg per month. So the chances of natural pregnancy depend directly and exclusively on current months egg and not on how many are left in the reserve for the future. There is no test for egg quality that can be done in advance. The only test for euploidy is genetic tests that can be performed on embryos after they are already fertilized and developed not on the egg.

Ovarian reserve testing does have some important use in fertility medicine. This test can tell us when a woman is getting close to menopause. AMH testing and antral follicle count can also indicate other potential reproductive issues, such as polycystic ovarian syndrome.