Have you ever wanted to look into a crystal ball to get a sneak peek at your fertility future? Your local infertility doctor may not be clairvoyant, but he or she can assess your fertility potential, especially if having children is important to you.
The following tests can help fertility providers determine the current status of your baby-making potential. All are relatively inexpensive as well as easy to administer, and the results can serve as a barometer of your ovarian reserve or egg supply.
Follicle Stimulating Hormone (FSH) Test
The follicle stimulating hormone (FSH) test measures the amount of FSH on day three of a woman's menstrual cycle. FSH is produced by the pituitary gland in the brain and stimulates the ovarian follicles, which is where eggs grow and are eventually released during ovulation. FSH also prompts the production of estrogen.
A normal FSH level is between 3-10mIU/ml. As ovarian reserve decreases, the amount of FSH in the blood increases while estrogen (estradiol) levels decrease. This means the pituitary gland is working harder to produce more FSH in order to stimulate the ovaries.
Estradiol Level (E2)
By itself, a normal FSH level is not sufficient to describe your fertility health. We also want to measure estradiol (E2), a key form of estrogen produced by the ovaries, on day three of a cycle. Doctors evaluating your results will look for a high level of this hormone. It encourages the growth of the uterine lining and also stimulates the pituitary gland to release luteinizing hormone, which is essential for ovulation.
E2 and FSH have a complementary inverse relationship with each other. While the production of FSH causes the release of estrogen, estrogen inhibits the production of FSH.
Anti-Mullerian Hormone Test (AMH)
This test checks a woman's ovarian reserve or egg supply by measuring the size of its pool of remaining microscopic or primordial follicles. Cells in the developing egg sacs or follicles secrete AMH. A low AMH level indicates a waning egg supply. It can be performed on any day of the menstrual cycle.
It is important to know that a high AMH value can be symptomatic of polycystic ovarian syndrome and is a measure of egg supply, but not necessarily egg quality.
Antral Follicle Count
Performed by vaginal ultrasound, this exam is used to count antral follicles, which are resting or primordial follicles that remain in the ovary waiting to be eventually released. It is also an indicator of how well a woman might respond to ovarian stimulation medications used during IVF.
Assessing Your Test Results
No one test is sufficient, and many fertility physicians like to conduct all four tests to obtain the most likely scenario of fertility potential.
Women are born with their lifetime supply of eggs. Though there is nothing they can do to increase or improve this supply, they can be proactive in becoming educated about their own reproductive health. Knowledge is power and these tests can provide you with a baseline of your ovarian reserve.
A fertility checkup may motivate you to either start trying to conceive earlier than you had originally planned or to freeze your eggs for use when the time is personally right for you, especially if your test results are determinative of a healthy reserve. Though they are not a guarantee of what the future holds, these assessment tests are a good start for taking charge of your fertility.