Ovarian reserve tests can help to predict how well your ovaries are aging which can give you valuable information when planning fertility treatments. Test results can indicate how successful an IVF might be, and help to determine the kinds of IVF protocols that may help to give you a better chance of conceiving successfully. Some clinics specialize in helping women with ovarian reserve issues and a diagnosis is the first step to getting the help you need.
There are five tests which together help you to have a good peak at how your ovaries are doing, and they are best done on day 3 of your menstrual cycle:
Antimullarian hormone (AMH)
Ovarian antral follicle count by ultrasound
Ovarian reserve testing is especially indicated if you are over 35 years of age, or if you have an unusually high FSH for your age. An FSH under 10 is considered to be good by many fertility specialists, but if your FSH is close to ten when you are in your late twenties or early thirties, ovarian reserve testing may be useful to see if you have prematurely aging ovaries. If your FSH is between 8 and 10 ovarian reserve testing can be very useful to give a bigger picture of ovarian age.
Many clinics do not offer ovarian reserve testing before IVF, and your first IVF cycle becomes a rather expensive test of how well your ovaries are doing. If your cycle shows poor IVF response - low number of eggs collected - you may be diagnosed with poor ovarian reserve and then be offered another IVF, more suited to your new diagnosis. Fortunately there is a simpler - and cheaper - way of getting this valuable information before you cycle.
There is considerable merit in checking in on how your ovaries are aging through a batch of blood test instead of through a failed IVF cycle. Aside from the obvious cost benefits, a different IVF protocol - better suited to low ovarian reserve - can be chosen to help up the odds of success if your ovarian reserve problem is diagnosed BEFORE your first IVF.
Physicians familiar with tweaking IVF cycles to optimize ovarian response may use protocols such as: a micro-dose lupron flare IVF protocol, an estrogen-priming IVF protocol, a combined cycle or an agonist cycle. All these cycle variants are used to help women have greater success when ovarian reserve is an issue. Choosing a physician who is VERY familiar with these cycles is your best option.
Once you know that you have an ovarian reserve problem, other aspects of an IVF protocol become important to tease out before committing to where and how you should cycle, you need to do your homework.
It becomes more important than ever to check out - through SART or the CDC - how successful your clinic is with the 37 yr+ age group. Also, how successful is the clinic is in freezing and thawing embryos if you have extra? Choosing a clinic that uses vitrification means that you are very unlikely to lose any of your embryos as they thaw which becomes very important if you may have few to begin with.
IVF clinics have very variable frozen cycle success rates but they can be an important determinant of where you cycle. Some clinics such as CCRM (Colorado Center For Reproductive Medicine) have excellent success rates with women with poor ovarian reserve and are a good benchmark to become familiar with.
Wherever and whatever you choose remember that the things that you do to to improve your fertility may be the greatest determinant of your success. Studies show that using a vitamin cocktail of melatonin, myo-inositol and other nutrients alongside a whole food organic diet could tip the odds further in your favor.