Want to know about your egg reserve? (All about Ovarian Reserve Testing)

Have you and your husband been hoping for a baby for a while now? It's normal for things to come to mind. "Why not yet?", "Is there something wrong with me?" It's very normal to feel a little scared and worried when things like that come to mind. When you go to see a doctor at a time like this, one of the tests that is done to check your fertility is called Ovarian Reserve Testing. Today, we'll talk about this simply, in a way that you can understand.

Simply put, what is Ovarian Reserve Testing?

Okay, let's put it this way. Every woman is born with the full number of eggs she will need for her lifetime. These are stored in the ovaries. We don't make new eggs. This collection of eggs we have is simply called our "ovarian reserve." This number of eggs naturally decreases as we age. Ovarian Reserve Testing is a test that gives a rough idea of ​​how many eggs are currently left in your ovaries. It compares your egg reserve to other healthy women your age. It mainly uses a blood test and a vaginal ultrasound.

In what cases would a doctor recommend this test?

Not everyone is usually asked to have this test. There are several main reasons why your doctor may recommend this test:

• If you are planning to start fertility treatments like IVF: These treatments involve giving you hormone injections to stimulate your ovaries . Knowing your egg reserve will help your doctor decide the dose of hormones you need to give you and give you a rough idea of ​​the success of the treatment.
• If you have had a medical condition such as cancer and have been treated for it: Chemotherapy or radiation therapy for cancer can damage the eggs in your ovaries. This test helps to determine the impact on your egg reserve at such a time.
• If you have had surgery on your ovaries: Surgery on your ovaries can also cause a decrease in egg production.
• If someone in your family (mother, sister) has had early menopause : Sometimes this can be hereditary. So it's important to know your condition early.

How is this Ovarian Reserve test done?

This test consists of three main parts. That is, the doctor understands your condition by combining the results of three related tests. Now let's look at what happens in each of these tests in a little more detail.

1. Anti - mullerian hormone (AMH)

This is the most commonly used test today. This hormone called ``(AMH)`` is produced by the tiny egg follicles in your ovaries. Imagine, if you have a lot of these egg follicles in your ovaries, the amount of AMH produced is also high. If the number of egg follicles is low, the AMH level is also low. That is, the AMH level is a good indicator of the size of your egg reserve . One of the advantages of this test is that you can do this blood test at any time during your menstrual cycle. Generally, if the AMH level is less than 1 ng/mL, it means that your egg reserve is decreasing. But it does not mean that you will not be able to have a child.

2. Follicle-stimulating hormone (FSH)

This is a hormone that works a little differently. The hormone FSH is produced by the pituitary gland in your brain. Its job is to go to the ovaries and give them a signal, “Okay, start developing an egg now.” Imagine that your ovaries have plenty of eggs and they are working well. Then the brain doesn’t have to work hard to give the signal. When you send a small amount of FSH, the ovaries start working. However, if the ovaries have fewer eggs and their functioning is a little weak, the brain has to shout, “Work hard!” That means producing more FSH. So, a high level of FSH in your blood means that your brain is working hard to get the ovaries to work. This suggests that your ovarian reserve may be low. This test is usually done on the third day of your menstrual cycle .

3. Antral follicle count (AFC)

This is not a blood test, it is a scan. A ``Transvaginal ultrasound`` is a scan done by inserting a small instrument through the vagina. This allows the doctor to directly see and count the number of small egg follicles (antral follicles) in both of your ovaries that are likely to start developing that month. These follicles are where the eggs are located. So a high number means that your egg supply is good. A low number means that your supply is low. This scan is also usually done within the first four days of your menstrual cycle.

What are the reasons for the decrease in egg reserves?

The main and biggest factor affecting your ovarian reserve is age . We cannot change that. Think about it, when we are born, we are born with millions of eggs. By the time we reach puberty, that number has dwindled to hundreds of thousands. After that, even though one egg is released every month, hundreds or thousands of eggs are destroyed in the process. So after the age of 35, the rate at which these egg numbers decrease accelerates. In addition to age, there are several other factors that can affect:

• Surgeries performed on the ovaries.
• Chemotherapy or radiation treatments for cancer.
• Severe pelvic area infections.
• Women in the family have experienced early menopause.
• Some genetic conditions.

The difference between egg quantity and quality

This is a confusing question for many people, but it is very important. Ovarian Reserve Testing only gives a rough idea of ​​your egg supply . That is, how many eggs you have. However, egg quantity alone is not enough to make a baby. The quality of those eggs is also very important. Quality is the genetic health of the egg. Only a healthy egg can combine with a sperm to create a healthy embryo. As the number of eggs decreases with age, so does the quality of the eggs. This quality declines especially rapidly after the age of 35. That is why the probability of having children decreases with age and the risk of miscarriages and having children with genetic defects increases.

So, can't I increase my egg reserve?

The direct answer to this question is, “No.” Because we cannot artificially increase the number of eggs we are born with. It is like a fixed deposit in a bank, we can only withdraw from it, we cannot add new ones. However, there is something we can do. That is, try to keep the quality of the eggs we have at a good level. Our lifestyle has a lot to do with that.

• Eat a balanced, nutritious diet. Include fresh vegetables, fruits, nuts, and fish in your diet.
• Get enough sleep. Get at least 7-8 hours of good sleep a day.
• If you smoke, stop today. Smoking is fatal to eggs.
• Stop or greatly limit alcohol use.
• Control your weight. Obesity can cause hormonal imbalances and affect egg quality.
• Reduce stress. It is very good to engage in things like yoga and meditation.

Although doing these things won't increase your egg count, it will help greatly in maintaining the health of the eggs you have. Ovarian Reserve Testing, Ovarian Reserve, Egg Count, Fertility, Childbirth, IVF Sri Lanka, AMH test Sinhala, FSH test Sinhala