The quality of a woman’s eggs is the most important factor in achieving pregnancy naturally. A woman’s AMH level is an indirect indicator of the number of eggs in the ovaries – it is not an indicator of egg quality. Therefore, AMH levels are not a valid predictor of a woman’s ability to conceive.
Recent Studies: AMH Levels, Age & Conception
A woman is born with a fixed number of eggs in her ovaries. This lifetime supply is not replenished by the spontaneous growth of new eggs during her reproductive years. There are several methods of testing the reserve (supply or quantity) of eggs remaining a woman’s ovaries.
A recent study published in J.A.M.A in 2017, over 700 women – ages 30 to 44 years – were studied.
- Did not have a history of infertility
- Had been trying to conceive for 3 months or less
The women with low AMH levels – indicating low ovarian egg reserve – did not have a reduction in their rates of conception when compared to a similar group of women who had a greater supply of eggs in their ovaries (as indicated by higher AMH levels).
In this study, the pregnancy rates of both groups were virtually the same.
- 62 percent vs. 65 percent at 6 months
- 70 percent vs. 78 percent at 12 months
It is important to note that most of the conceptions occurred within the initial 6 cycles of unprotected intercourse.
A recent study by a group of Danish researchers produced similar results to this study and further observed that the time to pregnancy was actually shorter in the low AMH group. Natural conception was observed in women with a wide range of AMH-levels – including women with undetectable serum-AMH levels.
Ovarian Reserve Tests
A woman’s ovarian reserve determines the capacity of her ovary to provide egg cells that are capable of fertilization resulting in a healthy and successful pregnancy. The following procedures are ovarian reserve tests commonly used to determine a woman’s present egg supply.
- Antral Follicle Count Test
- Day 3 FSH and E2 Test
- Clomiphene Challenge Test
- AMH Test
Antral Follicle Count Test
Counting the number of 2-9mm diameter antral follicles that can be seen with transvaginal ultrasound can estimate a woman’s ovarian reserve.
Day 3 FSH and E2 Test
Follicle Stimulating Hormone (FSH) and Estradiol Test (E2) measures the baseline of a woman’s FSH on day 3 of her menstrual cycle.
This test can indicate that a woman is close to menopause and has a low ovarian reserve. If a woman’s Day 3 FSH is elevated, her ovarian reserve is low to the point of being infertile.
Clomiphene Challenge Test
A clomiphene challenge test is a test that can discover cases of poor ovarian reserve that are still showing a normal day 3 FSH.
The Anti-Mullerian Hormone test checks the blood levels of the hormone AMH to evaluate a woman’s ovarian reserve.
Effect of Aging on Ovarian Reserve
As a woman ages, her ovaries are unable to produce the hormones that stimulate egg follicles to develop and make them reach a viable stage of development. To determine whether a woman can conceive with her existing egg supply, age is a determining consideration.
A woman’s supply of eggs will be used up somewhere between 25 and 55 years of age. Poor genetic quality of eggs results in infertility, even when there are many eggs remaining in a woman’s ovarian reserve.
A woman’s egg quantity and quality can be:
- Average for her age
- Better than average
- Worse than average
- A 45-year old woman can have good egg quality – although this is rare
- A 25-year old woman can have very poor egg quality and be infertile as a result
A woman in her 40s may still be able to ovulate, but her healthy eggs may have been depleted and those remaining are of a poor quality, potentially leading to an increased chance of an abnormal pregnancy.
Ovarian Rejuvenation Therapy
Ovarian Rejuvenation Therapy is an innovative Assisted Reproductive Technology (ART) procedure used to wake up and coax a woman’s nonfunctioning ovaries into producing viable eggs. Dr. Hugh Melnick is one of a handful of fertility doctors offering ovarian rejuvenation therapy.
Ovarian Rejuvenation Therapy involves the injection of a woman’s Platelet Rich Plasma (PRP) directly into her ovaries. The expected clinical result from this procedure is to induce Growth Factors to help the ovaries functioning again – even post-menopause.
How to Know if You’re a Candidate
Your initial consultation to find out if you are a candidate for Ovarian Rejuvenation Therapy can be conducted with the Doctor via telephone, Skype or FaceTime.
- Print your intake form by clicking here
- Print your information and consent form by clicking here
- Complete, scan and email these forms to email@example.com.
Fertility Doctor Specializing in Ovarian Rejuvenation Therapy
To read more about Ovarian Rejuvenation Therapy, check out the Doctor’s Blog here.
Schedule your initial consultation with Dr. Hugh Melnick at Advanced Fertility Services by calling 212.369.8700 – or – clicking the icon below.