Ovarian reserve is an important part of female fertility.
It refers to the number and quality of eggs remaining in a woman’s ovaries.
Every woman is born with a fixed number of eggs.
This number naturally decreases with age.

When a woman faces difficulty in getting pregnant, one of the first steps is checking ovarian reserve.
This helps doctors understand fertility potential.
It also guides treatment decisions.

An infertility specialist in Lahore uses medical history, blood tests, and ultrasound scans to assess ovarian reserve accurately.

What Is Ovarian Reserve?

Ovarian reserve means how many eggs are left in the ovaries and how healthy they are.
Both egg quantity and egg quality matter for pregnancy.

A good ovarian reserve does not always guarantee pregnancy.
A low ovarian reserve does not always mean pregnancy is impossible.
However, it helps doctors choose the right fertility treatment.

Why Is Ovarian Reserve Testing Important?

Ovarian reserve testing helps in many ways.

It shows how the ovaries may respond to fertility medications.
It helps decide whether IVF, ICSI, or other treatments are suitable.
It gives a realistic picture of fertility chances.
It supports proper treatment planning without delay.

This assessment is useful for women who are:

• Over 30 years of age

• Facing unexplained infertility

• Having irregular periods

• Planning IVF or ICSI

• Having a family history of early menopause

• Previously treated for cancer

Initial Consultation and Medical History

The assessment starts with a detailed consultation.

The doctor asks about age, menstrual cycle, and overall health.
Cycle regularity gives clues about ovulation.
Short or irregular cycles may suggest reduced ovarian reserve.

Past pregnancies and miscarriages are discussed.
Previous fertility treatments are reviewed.
Lifestyle factors like smoking, stress, and weight are also considered.

This step helps doctors decide which tests are needed.

Blood Tests for Ovarian Reserve

Blood tests are a key part of ovarian reserve assessment.
These tests measure hormone levels related to egg production.

Anti-Müllerian Hormone (AMH)

AMH is one of the most reliable tests for ovarian reserve.

It reflects the number of developing follicles in the ovaries.
AMH can be tested on any day of the menstrual cycle.
Low AMH suggests reduced egg reserve.
High AMH may indicate polycystic ovaries.

AMH helps predict how ovaries may respond to fertility drugs.

Follicle-Stimulating Hormone (FSH)

FSH is usually tested on day 2 or day 3 of the menstrual cycle.

High FSH levels may indicate poor ovarian reserve.
Low or normal levels are generally more reassuring.

FSH results are often interpreted with other tests for accuracy.

Estradiol (E2)

Estradiol is tested along with FSH in early cycle days.

High estradiol can sometimes hide high FSH levels.
This may give a false impression of normal ovarian reserve.

That is why doctors assess FSH and estradiol together.

Ultrasound Scan for Ovarian Reserve

Transvaginal ultrasound is another essential tool.

It provides a visual assessment of the ovaries.
The scan is usually done in the early days of the cycle.

Antral Follicle Count (AFC)

AFC measures the number of small follicles in both ovaries.

These follicles contain immature eggs.
A higher count suggests better ovarian reserve.
A low count may indicate reduced egg numbers.

AFC also helps predict response to fertility medications.

Ovarian Size and Structure

The ultrasound also checks ovarian size.

Smaller ovaries may suggest reduced reserve.
The doctor also looks for cysts or other abnormalities.

This scan is painless and takes only a few minutes.

Age and Ovarian Reserve

Age plays a major role in ovarian reserve.

Egg quantity and quality decline with age.
After the age of 35, this decline becomes faster.
After 40, pregnancy chances reduce significantly.

Doctors consider age along with test results.
Two women of the same age may have very different ovarian reserves.

Symptoms That May Suggest Low Ovarian Reserve

Some women may not have any symptoms.
Others may notice changes such as:

• Shorter menstrual cycles

• Missed periods

• Poor response to fertility drugs

• Difficulty conceiving despite regular cycles

Testing is the only reliable way to know ovarian reserve.

Can Ovarian Reserve Be Improved?

Ovarian reserve cannot be increased naturally.
The number of eggs cannot be restored.

However, egg quality may be supported with lifestyle changes.

Doctors may suggest:

• Healthy diet

• Weight management

• Stress reduction

• Stopping smoking

• Managing hormonal disorders

Early diagnosis allows timely fertility treatment.

How Ovarian Reserve Affects Fertility Treatment

Ovarian reserve results guide treatment planning.

Women with good reserve may respond well to IVF stimulation.
Those with low reserve may need tailored medication doses.
Some may be advised not to delay treatment.

In certain cases, doctors may discuss options like egg freezing or donor eggs.

Each treatment plan is personalized.

Emotional Support During Assessment

Ovarian reserve testing can be stressful.

Doctors explain results clearly and honestly.
Patients are guided with realistic expectations.
Emotional support is an important part of fertility care.

Understanding results helps couples make informed decisions.

When Should Ovarian Reserve Be Tested?

Testing is recommended when:

• Trying to conceive for over a year

• Over 35 and trying for six months

• Planning IVF or ICSI

• Family history of early menopause

• Previous ovarian surgery

Early testing can save valuable time.

Final Thoughts

Ovarian reserve assessment is a vital step in fertility care.
It provides insight into egg quantity and quality.
Blood tests and ultrasound scans work together for accurate results.

With proper assessment, fertility treatment can be planned more effectively.
Early evaluation gives better chances and clearer direction.