Women over the age of 35 years, who have unexplained infertility, are usually requested to test their ovarian reserve. This is a blood test on Day 3 of your cycle that can predict approx. how many resting eggs you have left in your ovaries.The test is a screen for the Anti-Mullerian Hormone (AMH) which is a protein hormone that your immature follicles secrete. The level of this in your blood is used to determine your ovarian reserve. Some fertility specialists are critical of the inter-cycle and daily variability of the AMH test, and suggest that at least 2 tests are performed, one month apart, followed by an Antral Follicle Count ultrasound. This is a specialised ultrasound that looks inside your ovaries, and counts the number of antral (immature) follicles. When combined, these 3 test results can give a more accurate prediction of your ovarian reserve1.
We can't.
Research has shown that the age at which your own mother went through menopause can help to estimate your current ovarian reserve. The earlier the age your mum started menopause, (before age 45 is highest risk) the less egg reserve you will have2.
So essentially this is set in genetic stone:
| High AMH (PCOS) | Over 3.0ng/ml |
| Desirable / Normal AMH | Over 1.0ng/ml |
| Low Normal AMH | 0.7-0.9ng/ml |
| Low AMH | 0.3-0.6ng/ml |
| Very low AMH | Less than 0.3ng/ml |
On the up side, recent research suggest that while we can't change the amount of eggs left, we can reduce the rate of their deterioration by:
All cells are effected by environmental toxins and chemicals, your precious eggs included. Quit smoking. Researchers from the university of Copenhagen2 found that women who smoke have lower ovarian reserves than those who don't.
Common sense tells us that prolonged stress is bad for us, and now researchers have specifically looked at how chronic stress negatively effect ovarian reserve.3 It is vital that your stress is managed well if you want to increase your odds at conception.
Data suggests low vitamin D levels directly correlate to Anti-Mullerian Hormone levels, which are, in part, a reflection of your ovarian reserve, or egg supply.
References:
(1)de Carvalho, Ramalho,,de Sá Rosa e Silva, Japur, A., Silva R., dos Reis J., Ferriani R., Alberto.,de Sá R & Silva M. (2008). Journal of Assisted Reproduction & Genetics 25 (7) 311-322.
(2) Bentzen J., Forman J.,Larsen E., Pinborg A., Johannsen T., Schmidt L.,Friis-Hansenand L & Nyboe Andersen A. (2012). Maternal menopause as a predictor of anti-Müllerian hormone level and antral follicle count in daughters during reproductive age. Journal of Human Reproduction doi: 10.1093/humrep/des356
(3) Pal, Lubna.,Bevilacqua,Kris., Santoro & Nanette F. (2010) Chronic psychosocial stressors are detrimental to ovarian reserve: a study of infertile women. Journal of Psychosomatic Obstetrics & Gynaecology 31 (3) 130-139.