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49 years of age, wanted to start family. Should i get tested to know number of follicles left?

Mar 2013
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Practicing since : 1998
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Dear doctor please will you advise me im coming 49 years old I would like to start a family, my question if I should go to my doctor for some blood test to know how many eggs I have left as im approaching menopause. I wait for your reply. thank you.
Posted Mon, 14 Oct 2013 in Women's Health
Answered by Dr. Aarti Abraham 1 hour later
Brief Answer:

Detailed Answer:
Thanks for writing to us with your health concern.
At 49, you are rightly concerned about your capacity to form good quality and number of follicles ( eggs / oocytes ).
The ability of the ovary to form good quality eggs in good number is called the ovarian reserve, just like your cash reserves in your bank account.
A woman is born with a fixed number of eggs in the ovaries at birth, and during each menstrual cycle, they gradually get used up, until at menopause, they decline almost to zero.
After 40, this ovarian reserve steeply falls.
Fortunately, there are many modern ways to assess your current ovarian reserve.
As you are planning a pregnancy relatively late, you need to consult a Fertility specialist.
The ovarian reserve is estimated in two ways.
The first is a baseline pelvic transvaginal ultrasound scan done on day 2 of your menstrual cycle.
This would reveal the ovaries and show the number of baseline egg follicles.
The second way is through blood tests.
The most reliable indicator is a test that measures AMH ( anti mullerian hormone ). The levels of this substance closely parallel the capacity of the ovaries to form follicles.
A low AMH virtually indicates that your ovarian reserve is totally declining.
Other blood tests such as FSH on day 2 of the cycle will further provide evidence ( high FSH indicates poor ovarian reserve ).
These blood tests and ultrasound scan is a must before attempting conception, as , if your ovarian reserve is low, you would waste precious time in planning for a spontaneous pregnancy.
Also, please remember that right now , there are methods that assess numerically the QUANTITY of egg follicles.
The quality cannot be assessed by any test.
After 40, the rate of abnormal egg follicles increases, leading to corresponding increase in risk of having chromosomal disorders in the baby, such as Down's syndrome etc.
I wish you all the luck with your future.
Please feel free to ask for any further clarifications .
Above answer was peer-reviewed by
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