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July 6, 2017

Dear Fertility Specialists Medical Group in San Diego,
How can I check how many eggs I have left?
Thanks!

Sarah


Hi Sarah,

Thank you for your important question. At Fertility Specialists Medical Group in San Diego we get this question all of the time. Our current understanding is that women are born with every egg they will ever have. This means that, over time, your supply decreases and, therefore, age is a major predictor of fertility .

One of the best determinants of egg supply is an ultrasound that looks at the ovaries. During the ultrasound there are black circles or follicles that are seen on the ovaries. These follicles have zero or one developing egg within them. Your doctor will count the total number of follicles on each ovary and add them to get your Antral Follicle Count. This number is the first estimate of your egg supply. An ultrasound is included in your initial consult at Fertility Specialists Medical Group in San Diego. This number is not your total egg supply, but a representation of that supply. The majority of your eggs are actually in a quiet resting state and are too small to be seen on an ultrasound. Each month a percentage of them wake up and become responsive to signals from the brain and start to grow. These growing follicles are what we see on ultrasound. We use this number, in conjunction with blood tests, to estimate your egg supply. You won’t get an exact number of eggs you have, but a category such as good, medium, or low. The blood tests we use are: Anti-Mullerian Hormone (AMH), an Ovarian Assessment Report (OAR), and/or Follicle Stimulating Hormone (FSH) in conjunction with Estradiol (E2).

At Fertility Specialists Medical Group in San Diego we will review your history and discuss which of these tests are appropriate for you. In general, the higher your levels of AMH the higher your egg supply is. This is because AMH is released from the follicles that are seen on your ultrasound. So, the more follicles you have, the more AMH you have. Conversely, the higher your FSH, the lower your egg supply. That is because FSH is your brain’s volume nob for talking to the ovary and asking it to produce an egg. The lower your egg supply is the louder your brain has to talk to your ovaries (higher FSH) to produce an egg. The OAR is a computational algorithm that takes in to account your AMH, FSH, and E2 along with the other hormones: Inhibin (InhB) and Luteinizing Hormone (LH) as well as your age. The advantage of this test is that it can roughly predict how many eggs you would have with an IVF or egg freeze cycle.

I know this is a lot of information, Sarah, but the basics are that you have an ultrasound and blood tests to determine your ovarian reserve.

If you are interested in learning more about what testing would be right for you please come visit us at Fertility Specialists Medical Group in San Diego. As three female physicians’ deeply committed to helping women learn more about their reproductive health and take control of their own reproductive timeline we offer complementary egg freezing consults at Fertility Specialists Medical Group in San Diego.

Sincerely,

Dr. Maas

Fertility Specialists Medical Group

San Diego, CA

Carlsbad, CA