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How is poor ovarian reserve detected ?

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Infertility Specialist
Practicing since : 1982
Answered : 22 Questions
hi doctor,have a history of POS , three years back my ovulations stopped. i had done my follicle count test then . After that my gynae put me on harmonal therapy i.e pill called XXXXXXX .that was given to have my period regularly . I still want to concieve naturally . I came to know through web that there are lot of drugs to induce ovulation cycle and for related problems .Pls let me know my options .
Posted Wed, 18 Apr 2012 in Infertility Problem
Answered by Dr. Aniruddha Malpani 2 hours later

Thank you for posting your query.

I understand your concern.

I am very worried about your advanced age.

This suggests you may have poor ovarian reserve. Your ovarian reserve refers to the number of eggs that are available for fertilization.

You need to do the following tests to check your egg quality:

1. Blood level of AMH ( Anti Mullerian hormone). Since AMH is produced directly by the ovarian follicles, AMH levels correlate with the number of antral follicles in the ovaries. It has been documented that women with lower AMH have lower antral follicular counts and produce a lower number of oocytes compared with women with higher levels.

Normal AMH levels are 2.0 – 6.8 ng/ml.

2. Vaginal ultrasound scan to check her antral follicle count. An antral follicle count ( AFC) is one in which the doctor counts the number of antral follicles ( also referred to as resting follicles) present in the ovary on Day 3 using vaginal ultrasound scanning. Antral follicles are small follicles , usually about 2-8 mm in diameter. The number of antral follicles correlates well with ovarian response. A normal total antral count is between 15 and 30. If the count is less than 6, the prognosis is poor.

If your egg quality is poor ( because you have reached the perimenopause), then you cannot have another baby naturally.

Please do the tests and do email me the results at YYYY@YYYY with subject as Attention to Dr. Anirudh Malpani.

Time is now at a premium for you - please don't waste it ! When you are 50 years old and looking back at your life, you should never have any regrets that you left any stone unturned and didn't give yourself the best shot at fertility treatment. Treatment can be expensive, but a baby is priceless !

We look forward to helping you to complete your family !

Above answer was peer-reviewed by
Follow-up: How is poor ovarian reserve detected ? 2 hours later
Dr malpani , thanks for your reply ,
Dr i was transferred on the harmonal therapy i.e on XXXXXXX due to irregular or missing periods and also just after the last follicile count test results were nil . However i will get the fresh test done , but is ther any hope after that
Answered by Dr. Aniruddha Malpani 16 hours later
Thanks for the follow up.

I will be able to reply intelligently once you do the tests I had asked for.

I will not be able to suggest you anything till you get the results.

Wishing you good health.
Above answer was peer-reviewed by
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