When evaluating ovarian reserve, when we talk about diminished ovarian reserve, we can refer to the quality of the oocytes, their quantity or reproductive potential. The identification of diminished ovarian reserve is of crucial importance in the initial evaluation of our practices.
There is no ideal test to analyze this parameter. Nor is there a reliable test to predict pregnancy potential. There are multiple tests to evaluate it, such as antimullerian hormone, antral follicle count or FSH, and estradiol levels in the first phase of the menstrual cycle. These tests have good power to predict a poor ovarian response to our treatments, but not to measure the probability of pregnancy.
As for the antral follicle count, we know that it is more variable and is affected by various background conditions, such as the timing of the cycle or the use of oral hormonal contraceptives. However, it is a very useful test in initial counseling in our offices when no other complementary tests are available.
Antimullerian hormone, on the other hand, is a more stable determination. It is an early, reliable, and direct indicator of ovarian reserve decline. When assessing our patients for an IVF cycle, it is the parameter that is best related to the number of oocytes obtained after controlled ovarian stimulation. In favor, we find that its result is not affected by the moment of the cycle in which it is performed.