What is Ovarian Reserve? How to Test It. Can You Improve Your Egg Quality?
Ovarian reserve refers to a woman's reproductive potential based on the quantity and quality of her eggs (oocytes). As women age, both egg quantity and quality decline, affecting fertility. A diminished ovarian reserve doesn’t mean you can’t conceive naturally or predict when you’ll enter menopause. However, it does indicate that you have fewer eggs, which poses a risk to your fertility. If you undergo ovarian stimulation, you will likely retrieve fewer eggs. This article explains: • What ovarian reserve is and why it matters. • The most accurate tests to assess ovarian reserve. • Lifestyle factors that support overall reproductive health. Descrição do post.
FERTILITY AND INFERTILITY
3/17/20253 min read
1. What is Ovarian Reserve?
A woman is born with 1–2 million eggs, but by puberty, only about 300,000–400,000 remain. With each menstrual cycle, a number of eggs is lost, and only one matures for ovulation. By the time a woman reaches her late 30s and early 40s, the number and quality of her eggs decline significantly.
Why is Ovarian Reserve Important?
· It helps predict natural fertility potential.
· It determines the likelihood of success with fertility treatments.
· It indicates the timing of menopause.
Does Low Ovarian Reserve Mean Infertility?
Not necessarily. A woman with a low ovarian reserve can still conceive, but her chances decrease with age, especially after 35 years old.
2. How to Test Ovarian Reserve?
A. Hormonal Blood Tests
Test What It Measures Optimal Range
Anti-Müllerian Hormone (AMH). Ovarian reserve 1.0–4.0 ng/mL (ideal fertility)
Follicle-Stimulating Hormone (FSH). Ovarian function <10 mIU/mL (tested on Day 3 of the cycle)
Estradiol (E2) Egg development response. 25–75 pg/mL (Day 3 test)
Inhibin B. Ovarian activity. >45 pg/mL suggests good reserve
AMH is the most reliable marker, as it remains stable throughout the menstrual cycle.
FSH and estradiol levels are useful but may fluctuate from cycle to cycle.
B. Ultrasound Tests
Antral Follicle Count (AFC) – Measures the number of small follicles in both ovaries via transvaginal ultrasound.
High AFC (>12 follicles) = Good ovarian reserve.
Low AFC (<5 follicles) = Diminished reserve.
Ovarian Volume – Women with larger ovarian volume tend to have better fertility outcomes.
3. Factors That Affect Ovarian Reserve
A. Aging
· Egg count declines naturally after 30 and rapidly after 35.
· Egg quality decreases, increasing the risk of chromosomal abnormalities such as Down syndrome.
B. Lifestyle Factors
Smoking – Reduces ovarian reserve and advances menopause by 1–4 years.
Obesity – Alters hormonal balance, impacting egg quality.
Excessive alcohol – Lowers AMH and damages egg DNA.
C. Medical Conditions
Polycystic Ovary Syndrome (PCOS) – Can result in higher AFC but poorer egg quality.
Endometriosis – Causes ovarian damage, reducing egg supply.
Autoimmune diseases – May lead to early ovarian failure.
D. Family History
· A family history of early menopause increases the likelihood of low ovarian reserve.
4. Can You Improve Ovarian Reserve?
The Truth About Supplements and Egg Quality
· There is no proven way to increase the number of eggs a woman has.
· Some studies suggest that Coenzyme Q10 (CoQ10) may help mitochondrial function in eggs, but it does not reverse genetic aging.
· No supplement can prevent chromosomal abnormalities in eggs caused by age.
Best Strategies for Protecting Egg Quality
Lifestyle modifications – Avoid smoking, excessive alcohol, and maintain a balanced diet.
Consider egg freezing at a younger age – If planning delayed pregnancy.
Fertility assessment – Regular testing to understand reproductive health.
5. Fertility Treatments for Low Ovarian Reserve
Mild ovarian stimulation – Lower doses of fertility drugs for better egg quality.
Egg freezing (oocyte cryopreservation) – A great option for women with declining ovarian reserve who wish to conceive later.
IVF with preimplantation genetic testing (PGT-A) – Helps select chromosomally healthy embryos.
6. Conclusion: Why Ovarian Reserve Testing Matters
Ovarian reserve is a key factor in fertility, but a low reserve doesn’t mean pregnancy is impossible.
· AMH and AFC are the best predictors of ovarian reserve.
· Egg quality is just as important as quantity for successful conception.
· No supplement has been proven to increase egg quantity or reverse age-related decline.
Women considering pregnancy—especially after 30—should undergo fertility testing early to explore their options for natural conception or fertility preservation.
Would you like to assess your ovarian reserve? Book a consultation with a fertility specialist today!
References
Cardim, H.J.P. Vencendo a Dificuldade de Engravidar. Editora Pensamento-Cultrix Ltda, 2009.
American Society for Reproductive Medicine (ASRM). "Ovarian Reserve Testing: What You Need to Know." Fertility and Sterility, 2023.
Nelson, S.M. "Antimüllerian Hormone and Ovarian Reserve Assessment." Endocrinology and Metabolism Clinics of North America, Vol.50, No.3, 2021, pp. 485-500.
Wallace, W.H.B., & Kelsey, T.W. "Human Ovarian Reserve from Conception to Menopause." PLoS ONE, 2010.