Ovarian reserve
To test for ovarian reserve several factors come into consideration:
- 1. Age of the woman
- 2. Ultrasonography of the ovaries
- a .A large ovary includes generally more eggs than a smaller one – if without cysts
- b. A normal ovary is in general around 25 mm in length
- c. A small ovary – looking like a premenopausal ovary – is with only few egg cells and is generally less than 20 mm in greatest length
- 3. Hormonal assays:
- FSH or AMH may used for test of ovarian reserve
- a. AMH (ant Müllerian Hormone may be used throughout all days of a menstrual cycle. The higher the better.
- b.FSH. FSH can only be used as a measure if taken correctly – which is at a cycle day – WHEN NO ESTRADIOL CAN BE DETECTED. In Denmark this is less than 0,05 nmol/l (< 0,15 ng/ ml) If measured correct typically at day 2-4 in the cycle this may be concluded:
- 1. FSH < 7 iu / l: Normal
- 2. FSH 7-10 iu/l more stimulation may be needed.
- 3. FSH > 10iu / L. One would expect the woman to be low responder to stimulation and that only few eggs may be obtained by controlled ovarian hyperstimulation.
- 4. FSH > 15 iu/l – very, very difficult and most likely too late in life.
