Ovarian Reserve
Ovarian reserve refers to a measure of the biological competency of a woman’s oocyte/follicular complexes (egg and surrounding cells which assist in maturation of the egg). Diminished ovarian reserve refers to the diminished biological competency of a woman’s oocyte/follicular complexes and often correlates with age.
Because women are essentially born with the majority of the oocyte/follicular complexes they will ever have, the natural aging process is associated with a progressive diminution of ovarian reserve. Diminished ovarian reserve is clinically manifested by relative infertility initially, and eventually progresses to a complete nonfunction of the oocyte/follicular complexes with a lack of estrogen production and anovulation (lack of ovulation). This final state of diminished ovarian reserve is commonly known as menopause.
Measurement of the ovarian reserve is accomplished through the measurement of a day 3 FSH. Elevated levels of FSH on day 3 indicate that the pituitary gland must send more FSH hormone to the ovary to get an appropriate response. This indicates that the oocyte/follicular complexes remaining in the ovary are either less responsive or that there are fewer complexes able to respond.
Most assisted reproductive technology (ART) programs have determined at what day 3 FSH level treatments will not improve pregnancy rates over those achieved without treatment. In these cases, the woman is most effectively treated using oocyte donation. Your reproductive endocrinologist will perform this or another type of test (clomiphene challenge) which provides similar information. The cutoff level varies between laboratories therefore your physician will advise you regarding your test’s interpretation.
