How is ovarian reserve assessed before starting IVF, and what tests are performed to evaluate it accurately?
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Ovarian reserve can be assessed before starting In Vitro Fertilization (IVF) through various tests to determine the quantity and quality of a woman’s eggs. The following tests are commonly performed to evaluate ovarian reserve accurately:
1. Baseline Ultrasound: This helps measure the resting follicle count and overall health of the ovaries.
2. Day 3 FSH and Estradiol Levels: Follicle-stimulating hormone (FSH) levels on the third day of the menstrual cycle are measured. Elevated FSH levels can indicate diminished ovarian reserve.
3. Anti-Mullerian Hormone (AMH) Test: AMH is produced by the ovaries and reflects the number of remaining eggs. A higher AMH level indicates a better ovarian reserve.
4. Antral Follicle Count (AFC): This test involves counting the number of small follicles (2-10 mm) present in the ovaries. A higher AFC is usually associated with good ovarian reserve.
5. Clomiphene Citrate Challenge Test (CCCT): This test involves FSH measurements on cycle day 3 and 10 after taking clomiphene citrate. It helps predict ovarian reserve.
These tests collectively provide a comprehensive picture of a woman’s ovarian reserve, helping fertility specialists tailor the IVF treatment plan accordingly.
Ovarian reserve is assessed before starting IVF primarily through an antral follicle count (AFC) via ultrasound and blood tests measuring AMH levels and FSH on day 3 of the cycle.