Ovarian reserve testing provides us a baseline of your fertility health. The results of the ovarian reserve testing allows us to evaluate treatment plans and their success rates for you. An ultrasound and blood work are performed on day 2-5 of your menstrual cycle to determine the quality and quantity of your eggs.

Antral Follicle Count (AFC) Ultrasound

Purpose

An AFC ultrasound is performed to count the number of primordial (resting) follicles in your ovaries which is indicative of the total number of primordial follicles in your ovaries.

Procedure

Our ultrasonographer performs a transvaginal ultrasound to count the number of 2-9mm diameter antral follicles in your ovaries.

Preparation Instructions

Call with day 1 of your cycle so that we can schedule your AFC ultrasound which needs to be performed on day 2-5 of your menstrual cycle.

Results

There is an ideal range for the number (sum of both ovaries) of antral follicles based on your age. A high count may indicate polycystic ovary syndrome (PCOS) or hyper stimulation to medication. A low count may indicate a diminished ovarian reserve.

Blood Work

Purpose

Blood work is used to test the level of your follicle stimulating hormone (FSH), estradiol (E2), and anti-mullerian hormone (AMH) that help give an overall picture of the quality and quantity of your ovarian reserve.

Procedure

A nurse, medical assistant, or lab technician draws your blood.

Preparation Instructions

Hydrate with plenty of fluids prior to your appointment so we can easily locate a vein to draw your blood.

Results

Follicle Stimulating Hormone (FSH)
FSH is the main hormone responsible for producing mature eggs. Your FSH is returned as a numerical value with an ideal range for your age. Low FSH results signal anovulation (when the ovary doesn’t release a mature egg), while extremely high FSH levels can indicate the onset of menopause.

Estradiol (E2)
E2, a type of estrogen, is secreted by the ovarian follicles as they grew and develop each month. Your E2 level is checked to help determine the accuracy of your FSH level. E2 suppresses FSH. If your FSH is normal but your E2 level is high, it indicates that your FSH is being artificially suppressed by E2.

Anti-Mullerian Hormone (AMH)
AMH is produced by granulosa cells during the primary, preantral and small antral stages. Production of AMH then begins to decrease and stops as follicles continue to grow. Since AMH is only produced in small ovarian follicles it is used to measure the size of the remaining egg supply. Your AMH is returned as a numerical value with an ideal range for your age. A very high or very low number can indicate a lower fertility potential.

In addition to ovarian reserve testing, an HSG and/or a SHG ultrasound may be needed to rule out blockages of the fallopian tubes and uterus. Learn more about all diagnostic testing here.