23/12/2018
How do you measure Egg Quantity?
There are blood tests that can be performed on day 2-3 of the menstrual cycle AMH, FSH
And a transvaginal ultrasound for antral follicle count.
WHAT IS AMH?
AMH, or Anti-Mullerian hormone, is a hormone that is made by granulosa cells that take care of the eggs, so the more eggs a woman has, the more granulosa cells she has, and the higher her AMH. We like to use AMH as a marker of a woman’s overall egg count. If the AMH is above 1.2, we feel relatively reassured, and if it’s less than 1.2, that is more concerning. Of course this will also correlate with a woman’s age, so a woman in her early 30s with a low AMH less than 1.2 is very worrisome, whereas it’s more common for women in their early 40s to have a low AMH.
What is FSH?
FSH, or follicle-stimulating hormone, is a hormone produced by the pituitary, an organ in the brain that encourages follicles and eggs to grow and mature each month. If the FSH level starts to go up, typically above the number of ten, that means that the brain is trying hard to stimulate the ovaries to produce eggs but having a hard time getting the ovaries to listen. So the FSH goes up and up, getting louder and louder and louder, trying to get the ovaries to listen – but there just aren’t many eggs left, so the ovaries are having a harder time producing.
What are fertility options for women with high FSH and low AMH?
If a woman has diminished ovarian reserve, meaning an overall lower egg count, she still may have the opportunity to have children using her own eggs – it just depends on her relative level of eggs. If there are some there that we can access, typically we would do in vitro fertilization (IVF) to get to them and potentially even bank some so that the woman could use them in the future when her egg count would be expected to be even lower.
