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What infertile patients should know about Ovarian Function Test

There is a fundamental shift in society when it comes to conceiving. The main change is that women are planning parenthood at a later age once they have an established career. However, there is a caveat here, since fertility reduces as age advances. The most fertile period is before 30, and in their mid-30s, fertility drops rapidly. After crossing the 40s, medical help might be needed to conceive a child. 

In this changed scenario, Ovarian reserve testing is becoming increasingly popular as doctors attempt to predict their likelihood of achieving pregnancy. The test is most helpful for infertile couples, too. OFT is not a single test but rather a combination of blood tests and ultrasounds. It mainly indicates the diminished ovarian reserve (DOR) and can help in deciding whether to opt for an assisted reproductive technology (ART) or not. The couples visiting our ZIVA Fertility center, have questions regarding ovarian reserve testing, hence in this blog we are sharing information about the accuracy of this test, and the steps involved. 

What does an Ovarian Reserve Test Indicate

The American Journal of Obstetrics and Gynaecology notes that ovarian reserve testing is indicated in several situations, including:

  • Before undergoing infertility evaluation or treatment.
  • For planning which individual ART you should opt for.
  • In the event of a history of early menopause or premature ovarian failure.
  • Polycystic ovarian syndrome (PCOS).
  • For fertility preservation, if there is any treatment involving gonadotoxic agents.
  • Preparation for ovarian surgery in women of reproductive age.
  • Diagnosis and recurrence surveillance for granulosa cell tumours.
  • Perimenopause.
  • A BRCA-1 or FMR1 premutation.
  • It is mandatory in case a woman is considering elective egg freezing or oocyte donation.

Ovarian function testing

We at ZIVA fertility will assess your ovarian health by completing a physical and pelvic examination. We advise you to be completely honest about your medical history. Below are the preliminary steps in an OFT:-

  • Menstrual history of the patient and also of the relevant family members. When the periods are irregular, or there is either too much flow or no flow, it indicates a problem with ovulation. 
  • The Sexual history, as well as the contraceptive methods, adapted.
  • Earlier surgeries were primarily related to the pelvis.
  • Weight changes (either weight gain or weight loss). We will assess your nutritional status, diet, and history of anorexia or bulimia.
  • Stress levels in your life.
  • Any fitness routine that you follow
  • Dietary habits along with smoking and alcohol habits. 
  • Adrenal, thyroid and pituitary glands health are responsible for moderating vital reproductive hormones.

Blood tests to assess Reproductive Hormones – 

  • Firstly, in Ovarian reserve testing, follicle-stimulating hormone (FSH) levels are measured. FSH is a hormone associated with ovarian ageing. The best period to conduct this test is on the second or third day of a woman’s menstrual cycle. If the test results show elevated FSH levels on day two or three of the menstrual cycle, it indicates a reduction in the ovarian reserve.
  • Another hormone that is measured is estradiol, and its levels fluctuate throughout the menstrual cycle. Elevated levels on day three indicate dwindling ovarian reserve.
  • The third critical hormonal measurement used to estimate ovarian reserve is the anti-Mullerian hormone (AMH). This test is essential in perimenopausal women, and age-specific AMH values have been identified through various research studies. If AMH values are less than 1ng/ml, it means a diminished ovarian reserve.

Pelvic ultrasound

The primary purpose of ultrasound in an OFT is to count small (antral) follicles in the ovaries. We measure the number of hairs within pre-specified size ranges (i.e., 2-10 mm). In an ultrasound, the respective part of the body is exposed to high-frequency sound waves, producing an image of that area. The whole process is brief, non-invasive and painless. In an OFT, a pelvic ultrasound is done where a slender instrument called a transducer is inserted into the vagina. This transducer emits high-frequency sound waves and then listens for returning echoes from tissues in the body. The resultant image is viewed in ‘real-time,’ in which the health of the ovarian egg follicles and the health of the ovarian cysts are visible.

The Ovarian reserve test results do not definitively indicate fertility problems. The doctor should be careful while explaining to the patients that ovarian reserve deficiencies do not necessarily mean complete infertility. Be honest in your conversation about test results and the likelihood of achieving a viable pregnancy. One should take care of their ovarian health like the rest of the body. Adapting a healthy lifestyle, practising yoga and meditation, and leading a stress-free life are all crucial for a healthy reproductive system. Do consult our highly talented team of doctors at ZIVA at +91-9100002737, +91-9392834024 or visit our website –