Ovarian Reserve, Fertility Testing & Egg Supply

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Mario Fernando

By Mario Fernando

Your ovarian reserve is a key measure of your fertility. It is an indication of how many more good chances of ovulation you have; based on the number of follicles and eggs you have remaining.

Every healthy woman has two ovaries, and on average, each ovary contains about 400,000 follicles at birth. These follicles are used up over time and act as protective, nourishing capsules for the developing eggs inside of them.

Follicle development in ovaries
each ovary contains about 400,000 follicles at birth

To find out more about follicles, have a read of the articles on follicular development and hormones of the menstrual cycle.

In summary, here are a few quick things you need to know about follicles:

Where does ovarian reserve come into this?

The Ovarian Reserve is a measure of the number of follicles still remaining in your ovaries. This number decreases with age as your regular menstrual cycles and normal ageing process causes many follicles to be 'used up'.

A high ovarian reserve means you have a better chance of conceiving. Why is this? It's simple: with higher follicle number comes a higher amount of eggs. The more eggs you have, the longer you have to try and conceive.

How do I find out my Ovarian Reserve?

There are a few easy tests that can identify your ovarian reserve. The AMH test is the clinically preferred test. AMH stands for Anti-Mullerian Hormone, which is a hormone released by your follicles into your blood.

AMH levels do not change with your menstrual cycle and are released at a fairly constant rate by your follicles. Therefore, its levels correspond to the number of follicles in your ovaries.

What do the ovarian reserve test results mean?

What does age have to do with Ovarian Reserve?

Ovarian Reserve gradually decreases with age. The image below sums this up based on primordial follicle population from around conception to menopause. From around 400,000 at birth, to 1,000 at menopause.

Ovarian Reserve - Wallace Kelsey Model

Is there any way to improve a low Ovarian Reserve?

Unfortunately, no. There have been some research studies which have found that new eggs could potentially be produced in a female over her reproductive years. In the future, we could see bone marrow transplants and blood transfusions being used to increase Ovarian Reserve. However, because a woman is born with a certain number of follicles which are used up over time, replacing them is currently not possible.

It is also important to consider that Ovarian Reserve is not the only measure of fertility. In fact, it is only useful in giving you an indication of how much time you have left to conceive. It doesn't provide an indication of the quality of your eggs or follicles, only the number.

Other tests include ovulation tests and tests that check that all your reproductive organs are structurally sound. So when you get your AMH levels tested, just remember that Ovarian Reserve will only tell you how much more time you have to conceive.

It's a test especially relevant to older women trying to conceive, or to women who have continually failed to conceive. It's useful information to know, but even if you have a low Ovarian Reserve, it doesn't mean you won't be able to conceive.

How long have you been trying to conceive? Share your story or ask a question by leaving a comment below.

New Comments

  1. Sandra Oct 13, 2016
    I have just recently had my first IVF cycle, which unfortunately did not work. I had 6 eggs, but only 3 fertilised. I am 42 and was wondering how much time I have left to conceive?
    1. Christina (OC Team): I'm sorry your IVF attempt was unsuccessful. It's possible to conceive any time before menopause. Good luck! - (Oct 14, 2016)
  2. Sandra Oct 17, 2016
    Hi Christina, thank you for your response. I was under the impression after reading Mario's literature on ovulation reserve, that you can get a good indication on timescale depending on how many follicles you produce in each cycle? Is that not correct?
    1. Christina (OC Team): Do you mean your estimated onset of menopause? Yes, you can definitely talk to your doctor about ovarian reserve testing. - (Oct 17, 2016)
  3. Sandra Oct 19, 2016
    No, I was referring to the timescale in which I would be looking at to conceive? Is the ovarian reserve testing something that can potentially give you a estimated idea?
    1. Christina (OC Team): Ah, I see. That's a good question, but that's not exactly how it works. Think of it this way... A woman in her 20s will have a much higher ovarian reserve than a woman in her early 40s, so she has a better chance at conceiving. It may take three months or three years, but she has enough follicles to reasonably believe that it will happen. Whereas a women in her 40s does not have the same kind of time because her ovarian reserve would be much lower. Of course, there are many other factors that affect fertility, but this should illustrate the point. Ovarian reserve testing is a good idea if you want to estimate how much time you may have left to conceive. - (Oct 19, 2016)
  4. Sandra Oct 19, 2016
    Okay, I see what you mean. That makes sense. I will look into Ovarian reserve testing to give me a better indication on timescale. Thank you very much for the information. At least I have something to work with here!!!

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