If you’re having trouble conceiving, you may wonder about your ovarian reserve. That is, the number of eggs you have, and whether or not they’re healthy enough for successful fertilization. In addition to the natural aging process, you lose eggs due to several factors. They include genetics, treatment for cancer, autoimmune disorders, ovarian surgery, infections like STIs, and lifestyle factors, such as smoking and chronic stress. Also, you lose eggs due to extreme changes in your weight that could disrupt the balance of your hormones.
Your doctor may order certain tests if they suspect you have diminished ovarian reserve. The clearest indicator of a healthy egg reserve is your hormonal balance. Your doctor measures your follicle-stimulating hormone (FSH) and your estrogen levels. Normal levels, from a blood test taken on day three of your cycle, usually indicate a good egg reserve. Here, we look at an in-depth picture of how doctors measure normal FSH and estrogen levels, and what indicates further testing in determining your egg reserve.
How Your Doctor Measures Your FSH and Estrogen Levels
On the third day of your menstrual cycle, your doctor measures your FSH and estrogen levels. This is a baseline measurement to take a look at your reproductive function, based on your hormone levels. The third day after your period starts is ideal for measuring these hormones as a starting point. That way, your doctor knows if your hormones fluctuate later in the cycle.
Your doctor assesses your FSH and estrogen again around day ten of your cycle, and checks your estrogen level at the luteal phase, around mid-cycle, to ensure your hormones are in sync to prepare for a potential pregnancy by preparing your uterine lining.
What The Levels Indicate
Normal FSH and estrogen levels begin in your brain. There is quite a choreography of hormones that goes into reproduction. A hormone called Gonadotropin-releasing hormone stimulates your pituitary gland so it releases FSH into the bloodstream. The influx of FSH tells the ovaries it’s time for egg production. This prompts the Luteinizing hormone to trigger the release of estrogen, which aids in the maturation of your follicles that release the eggs.
But an imbalance of FSH or estrogen in any direction alerts your doctor to issues with your ovarian reserve. Here are the measurements your doctor looks at and what they indicate:
Good Ovarian Reserve
A good egg reserve depends on your ovaries’ response to the pituitary’s signal and release of FSH. If, on day three, your FSH is low and so is your estrogen, your egg reserve is good. Your doctor moves on to other tests or recommends starting treatment to overcome infertility.
Diminished Ovarian Reserve
If you have very few eggs or a diminished reserve, your FSH and estrogen are high. A high FSH indicates that your pituitary gland releases more FSH in an effort to stimulate your ovaries because fewer eggs remain. Additionally, the higher estrogen levels indicate fewer eggs and eggs of lesser quality.
After measuring your FSH and estrogen levels, your doctor may decide to investigate further.
The additional tests ordered are typically ones that measure the Anti-Müllerian Hormone, or AMH, one of the most reliable indicators of good egg reserve. The higher your AMH, the more you have in egg reserve.
Another reliable indicator of ovarian reserve is an ultrasound count of your remaining, or resting, follicles. Doctors perform the Antral Follicle Count (AFC) using transvaginal ultrasound.
What to Do if You’re Concerned About Egg Reserve
If you’re worried about your ovarian reserve or suspect you have infertility, please contact LA IVF today. Our doctors and staff understand your struggle to grow your family. Our knowledgeable professionals journey with you to reach your goal of having a baby. Request a consultation today.
