Ovarian Reserve Testing

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Having trouble conceiving or want to know more about your future chances of achieving pregnancy?

Are you interested in learning more about your ovarian reserve- simply put how many eggs are remaining in your ovaries?

For those trying to conceive either naturally or with the assistance if fertility treatments, ovarian reserve is a topic that can be often heard in the OB/GYN or reproductive endocrinology office - but what exactly does it mean and how does it affect you?

This post will help you better understand ovarian reserve, which tests to look for and how the results can help you influence current and future fertility. 

To that end, we’ve reviewed the two leading online direct to consumer health lab companies offering do-it-yourself ovarian reserve tests you can take from the privacy of your own home.  Here's how to get started testing...

Best At Home Ovarian Reserve Tests

 Ovarian Reserve Test by EverlyWell

Ovarian Reserve Test by EverlyWell

 Ovarian Reserve from LetsGetChecked

Ovarian Reserve from LetsGetChecked


Research Table of Contents

• What is Ovarian Reserve Testing
• How Does Ovarian Reserve affect Fertility
• EverlyWell Ovarian Reserve Test Review
• LetsGetChecked Ovarian Reserve Test Review

Researcher:  Lori Smith

Date:  August 21, 2018

 

What is ovarian reserve testing?

As a fetus, a woman’s ovarian egg count will start in the 6-7 million range, however during her lifetime, she will only ovulate upwards of 300-400.  As a woman ages, her fertility declines over time and the eggs remaining viable for future fertility begin to diminish.In most women, the optimal time in terms of fertility window is between the second and third decade of life, with a decline in fertility experienced through menopause at which time conception is no longer possible.

To evaluate for ovarian reserve to determine current and future fertility, many healthcare providers will recommend that certain tests be performed to evaluate fertility status and may include follicle stimulating hormone (FSH), anti-mullerian hormone (AMH) and antral follicle count (AFC)- an ultrasound procedure. Additional tests may be recommended based on a woman’s individual health and fertility status and should be discussed with a qualified healthcare provider such as a gynecologist or reproductive endocrinologist. 

For a woman’s reproductive system to function normally, there needs to be a harmonious balance of several hormones, some of which include:

  • Estrogen

  • Follicle stimulating hormone (FSH)

  • Lutenizing hormone (LH)

  • Prolactin

  • Testosterone

  • Thyroid stimulating hormone (TSH)


Within this article, we will briefly discuss some of the hormones needed for normal reproductive function. For a more detailed discussion on hormonal health, check out our article Home Based Hormone Testing for Women (and MEN) and Women's Fertility Test Review

What Hormones Should Women Test For?

You may be reading this wondering, what hormones should I be testing for and why? 

What hormones will give me the best insight into my ovarian reserve and offer information on my current and future fertility?

For around $80 you can find the answers you are looking for! 

When testing hormones for ovarian reserve, there are certain hormones that are checked to gain insight into your chances for current and future fertility- follicle stimulating hormone (FSH) or anti-mullerian hormone (AMH). What’s the difference and what to the results mean? Read on for more info!

 

Follicle Stimulating Hormone (FSH)

Follicle stimulating hormone or FSH is one of many hormones that plays an iatrical part in a woman’s fertility with levels varying throughout her cycle. In conjunction with luteinizing hormone  (LH), FSH has two vital functions within the menstrual cycle:

  1. Stimulation of egg growth

  2. Stimulation of estrogen production

For an accurate reading, FSH levels are obtained on day 3 of a woman’s menstrual cycle.The higher the FSH, the lower the ovarian reserve. A normal level for FSHat this time during a woman’s cycle is reported to be around 10, with 15 or above indicating low ovarian reserve. 

Anti-mullerian Hormone (AMH)

Anti-mullerian hormone or AMH is a blood hormone test which is commonly used in conjunction with the ultrasound procedure, an antral follicle count or AFC. AMH levels decline with age, however, testing for the hormone is not cycle day specific so it can be done any time of the month unlike FSH which has to be collected on day 3 of a woman’s menstrual cycle for an accurate reading.

While there is little variation in AMH levels during the menstrual cycle, the hormone naturally decreases with age and signify lower ovarian reserve in older women and women with lower than normal counts. For example, in women within the optimal fertility window, their AMH levelsmay range from 4.0-6.8 ng/mL, whereas a woman with low fertility may experience AMH levels in the range of 0.3 - 2.2ng/mL.There are other measurement levels to calculate AMH, so discuss with your healthcare provider which method is being used for an accurate interpretation of the results. 

AMH levels may be helpful to women who are:

  • Being evaluated for IVF

  • Evaluating ovarian reserve

  • Looking into their current and future fertility

Speak with your OBGYN doctor or other healthcare provider to see if home based ovarian reserve testing is right for you and how they can help to best interpret your results!

As always, you’ll want to speak with a qualified healthcare provider to determine your personal risk for infertility and what tests may be recommended. Certain hormone imbalances may be caused by minor issues or more potentially serious health conditions that need further evaluation by a healthcare provider.

Home based testing may be a useful tool for you and your healthcare provider to determine the best course of action to preserve your fertility, treat infertility or decide if more immediate plans for conception are right for you and we’ve reviewed our two recommended companies below.


Everly Well Women's Fertility Test Review

Price:  $79.00

Collection:  Blood, finger stick collection

Markers Measured:  Follicle‑Stimulating Hormone (FHS)

Restrictions:  Tests cannot be shipped to New York, New Jersey, Maryland and Rhode Island

The EverlyWell Women’s Fertility Test is an ideal home-based hormone testing method for women wanting to evaluate their hormone levels prior to conceiving and to evaluate their menstrual health. 

  • Results reviewed by physician- no follow up available. Recommended to present results to patients own healthcare provider.

  • Instructional videos

  • Itemized receipt for HSA/FSA reimbursements avaialble upon request and accept HAS/FSA payment

  • Online chat Monday-Friday from 9 am to 5 pm CST hours and very responsive

  • Email support available Sunday-Friday

  • Phone support Monday-Friday from 9 am to 5 pm CST

  • Accepts FSA/HSA payments and major CC payments

  • Results reviewed by physician- no follow up available. Recommended to present results to patients own healthcare provider.

  • Easy testing method with video instruction, great customer service, quick results turn around, Accept HSA/FSA payments

  • Testing only available certain US states and not abroad.

  • No app.

PROS

Easy testing method with video instruction, great customer service, quick results turn around, Accept HSA/FSA payments

CONS

Does not co-test for AMH. 

Testing only available certain US states and not abroad.

No app.

BOTTOM LINE

The EverlyWell Ovarian Reserve Test is ideal for women who are interested in knowing more about their ovarian reserve (how many eggs are in the ovaries) to determine fertility. 


LetsGetChecked Ovarian Reserve Review

Price:  $139.00

Collection:  Blood, finger stick collection

Markers Measured:  Anti-mullerian Hormone (AMH)

Restrictions:  Tests cannot be shipped to New York, New Jersey, Maryland and Rhode Island

  • App to activate kit

  • Online chat which is very responsive

  • Email support

  • Phonesupport

  • Instructional videos

  • Major payment methods accepted including PayPal, Visa, MC, Discover, American Express, Diners Club and JCB

PROS

Results are reviewed by medical professionals which include genetic counselors, specialists and registered nurses. LetsGetChecked offer a call from a registered nurse to talk about abnormal (positive) results to offer support and potential treatment options and offer scheduling of specialist consultations in private clinics.

Easy testing method with video instruction, great customer service, quick results turn around and test result support.

CONS

Does not co-test for FSH. 

BOTTOM LINE

The LetsGetChecked Ovarian Reserve Test is ideal for women wanting insight into their fertility, specifically the potential amount of eggs left in the ovary. It is also a great test for women who are interested in pursuing IVF to determine their possible response to fertility therapy.


Conclusion

Two things to think about before you order your at-home ovarian reserve test.  First, are you on the Pill?  Birth control and Age can dramatically impact your results.  Birth control in particular can dramatically reduce your AMH levels as tested by LetsGetChecked.  It's best to have cycled off the pill for at least 30 days prior to testing AMH levels.

Secondly, FSH vs AMH, is that the question? Or is it AFC (Antral Follicle Count as measured by an ultrasound)?  Only your own tests results, birth control status, age and a consult with your doctor can answer that for sure.  While these tests are a good starting point, it would be great if they offered a combined test of FSH and AMH together.  Each company reviewed here has decided to isolate a single co-factor in their respective tests.  

We are on the lookout for a combined test and will keep our free email subscribers notified as new tests hit the market. 


Article References:

1.    Female Reproductive System. (2012, May 14). Retrieved from https://my.clevelandclinic.org/health/articles/9118-female-reproductive-system

2.    Jirge, P.R. Ovarian reserve tests. (2011). J Hum Reprod Sci. 2011 Sep-Dec; 4(3): 108–113. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3276943/  

3.    FSH vs. AMH vs. AFC. (n.d.). Retrieved from https://www.fertilityauthority.com/articles-fsh-amh-afc

4.    Goldberg, J. and Krause, L. (2016, January 12). Retrieved from https://www.healthline.com/health/fsh

5.    AMH Test to Determine Fertility. (n.d.). Retrieved from https://www.drmalpani.com/knowledge-center/infertility-testing/amh