When women are seeking counseling for potential infertility, ovarian reserve testing is one of the most common blood tests that are ordered. It can be used as a screening tool to identify women who are the most unlikely to become pregnant prior to starting their first IVF treatment cycle. This can help women avoid the costs of IVF when their chances of achieving a pregnancy are low or go into the IVF cycles with realistic expectations.
What is the Ovarian Reserve?
When IVF cycles are initiated, the goal of treatment is to have a woman be able to produce several high quality eggs while maintaining a healthy internal environment. It is a measurement of how easy it will be for a woman’s ovaries to be stimulated to produce those eggs. This variable measurement is important because women are born with all of the eggs that will be individually produced over a lifetime. Most eggs are normal, but some will be unbalanced or abnormal from a genetic standpoint.
In most women, the best eggs tend to be ovulated first. As women age, there are fewer high quality eggs that are produced. This makes a woman less likely to respond to IVF treatments. This means age is a defining risk factor for overall fertility and why older women have low live birth rate percentages when using their own eggs for fertility treatments.
Why Is This Test Ordered?
Depending on a woman’s age, the ovarian reserve blood test may be ordered to determine the viability of even proceeding with an IVF treatment. Younger women under the age of 30 also respond poorly to ovarian stimulation for a wide variety of reasons, sometimes genetic in nature, and this can make it difficult to achieve a pregnancy.
Some women may also have eggs that are defined as being of “poor” quality because of past surgeries, infections within the pelvic region, smoking cigarettes, or cancer treatments that involve radiation or chemotherapy. Ovarian scarring from endometriosis may also cause a woman to struggle in achieving a pregnancy.
It may also be ordered when ultrasound screening for ovarian volume is either inconclusive or presents the possibility of difficult ovarian stimulation. Most women who have low ovarian reserve numbers will have only a few eggs at retrieval and this makes it difficult for the IVF cycles to be successful.
What Do My Test Results Mean?
The test results will either be listed as “normal” or “abnormal” for most medical providers. A normal test indicates that a woman will likely respond in a positive way to ovarian stimulation and that an IVF cycle may proceed, although without a guarantee that a pregnancy can be achieved. It simply means that there are no heightened risks that could prevent a pregnancy from occurring.
Abnormal results indicate that a woman may respond poorly to ovarian stimulation and have a lower chance of achieving a conception and/or a live birth compared to women who have a normal result with this blood test. This is because there are fewer overall genetically balanced eggs that can be retrieved during ovarian stimulation.
If abnormal results are received, one of the first questions that will be asked is in regards to the importance of having a biological child. Counseling is often recommended and options that include donor eggs may become available depending on all test results. Not all medical providers recommend pursuing IVF with abnormal results, so it is important to address this potential issue and the costs of frequent insemination cycles.
Women who have received abnormal ovarian reserve blood test results have taken home happy and healthy children in the past. Receiving an abnormal result is not a specific diagnosis for the future. It simply means that there are more risks and chances of failure when pursuing IVF treatments. It is important to ask for a second opinion and be aggressive in obtaining specific information regarding what the test results mean.
When exploring the possibility of having children, it is important to explore all available treatment options. Ovarian reserve testing is more of a measurement of the difficulties and costs that women will be facing in the future to achieve a pregnancy. Only a medical provider can interpret the results of the ovarian reserve blood test to let women know what their specific risk factors may be. Ask for a second opinion on abnormal results so that all of the pros and cons of proceeding with IVF cycles can be evaluated so the best decision possible can be made.