How many eggs do I have left? What you need to know about testing.

Are you interested in assessing your fertility, even if you're not currently planning to start a family? In today's world, where infertility rates are on the rise, many of us are naturally curious and eager to take control of our reproductive health. Discussions around hormonal and fertility have gained prominence. While the most definitive way to determine fertility is attempting to conceive, several tests can provide insights into your future fertility prospects.

One key factor impacting fertility is age, which affects egg quality, and quantity, Though assessing egg quality remains a challenge, you can gain some understanding of egg quantity through some tests. Here are three tests that can offer some insights:

1. FSH (Follicular Stimulating Hormone): FSH is the hormone responsible for s the growth of eggs in preparation for ovulation. As our egg reserve declines, FSH levels tend to increase as the body attempts to stimulate more egg growth.

2. AMH (Anti-Mullerian Hormone): AMH is a hormone produced by cells in the ovarian follicles. AMH plays a crucial role in the development of female reproductive organs and the regulation of the ovarian cycle. AMH testing can estimate your ovarian reserve.  This is one of the more well-known tests, and there are at-home kits available. Extremely high AMH levels can indicate conditions like Polycystic Ovary Syndrome (PCOS), while low levels may suggest a diminished egg reserve. It's important to note that AMH levels can fluctuate and even be affected by things like vitamin D deficiency. They are best utilized in fertility treatments to gauge patients' responsiveness to medications. Many people still conceive with a low AMH.

3. Antral Follicle Count: This test involves a transvaginal ultrasound and is typically conducted between days 3 and 5 of your menstrual cycle when follicles are developing in preparation for ovulation. The test counts the number of developing follicles in your ovaries at that time, which decreases with age, providing another estimate of your remaining egg count.

It's crucial to understand that none of these tests should be interpreted in isolation. The complete clinical picture is what matters, and healthcare professionals will review the results in context to make informed decisions about your fertility. Traditionally, these tests are conducted for individuals facing difficulties in conceiving, rather than the average person. Many individuals with a lower ovarian reserve can still conceive naturally.

Remember, proactive fertility management extends beyond these tests. It includes monitoring other hormones, tracking your menstrual cycle, and focusing on overall health. Your general well-being can influence your fertility.

Sources:

Deadmond A, Koch CA, Parry JP. Ovarian Reserve Testing. [Updated 2022 Dec 21]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279058/

Roudebush WE, Kivens WJ, Mattke JM. Biomarkers of Ovarian Reserve. Biomark Insights. 2008 Apr 16;3:259-268. doi: 10.4137/bmi.s537. PMID: 19578510; PMCID: PMC2688347.