Day 3 FSH and Estradiol, Antral Follicle Count and Anti-Mullerian Hormone
Ovarian reserve testing is an attempt to estimate the size and quality of the remaining ovarian follicular pool. Ovarian reserve essentially estimates the likelihood of success with treatment using the patient’s own eggs. Ovarian reserve tests include both blood tests and ultrasound examination of the ovaries.
Diminished ovarian reserve may be suspected by elevation in either the FSH or the estradiol. The FSH levels will vary somewhat by the endocrine lab and the assay used. Unfortunately the prognosis is based on the highest, but not necessarily the most recent, FSH level. It is advisable to obtain an opinion and possible further testing from an infertility specialist for those patients with abnormal levels, especially those under age 35.
An antral (early) follicle count can be used to further clarify the patient’s ovarian reserve. This is done on or about the third day of the cycle with an ultrasound examination. Antral follicle count is the sum total of all follicles in both ovaries that are 4-8 mm in average diameter.
Recently, anti-Mullerian hormone (AMH) is advocated as an additional marker for ovarian reserve. Unlike FSH level, AMH level does not fluctuate with the menstrual cycle or affected by medications such as birth control pill.
For more information on Ovarian Reserve, Age and Fertility:
Ovarian reserve (predicting fertility potential in women)
Does My Age Affect My Fertility
Reproductive aging in women
Age and Fertility