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Is there a relation between ovarian reserve and egg quality?

By Mark P. Trolice.
Last Update: 03/14/2019

Ovarian reserve is a measure of the quantity and quality of the eggs; it is best measured by a combination of chronological age, antral follicle count (AFR) on ultrasound, and anti-mullerian hormone (AMH).

An AFR of less than 11 reflects diminished ovarian reserve and less than 6 is severe. AMH levels below 1.6 have been shown to reduce the number of eggs retrieved with IVF and may predict pregnancy outcome. Levels below 0.4 are severe.

Using a test to detect a low ovarian reserve in a low-risk population will result in a greater number of false-positive results (i.e. characterizing a woman with low ovarian reserve when she actually has a normal ovarian reserve). A recent article in JAMA showed no difference in natural pregnancy rates in women aged 30-44 years, regardless of HMA levels.

Very low levels of AMH (<=0.4) affect the outcome of IVF cycles. In 2016, a study on Fertility and Sterility, using SART data from a population of women with an average age of 39.4 years, the cycle cancellation was 54%; of all recovery attempts, oocytes were not obtained in 5.4% and no embryo transfer occurred in 25.1% of cycles; and the live birth rate per embryo transfer was 20.5% (9.5% at the beginning of the cycle and 16.3% at the puncture) from an average age of 36.8 years.

Suggested for you: How Many Eggs Does a Woman Have? – Your Egg Count by Age and What Can Ovarian Reserve & AMH Tests Tell Us?.

 Mark P. Trolice
Mark P. Trolice
MD, FACOG, FACS, FACE
Reproductive Endocrinologist
Mark P. Trolice is the Director of Fertility CARE – The IVF Center and Clinical Associate Professor in the Department of Obstetrics & Gynecology (OB/GYN) at the University of Central Florida College of Medicine. He is Board-certified in REI and OB/GYN, and maintains annual recertification. His colleagues select him as Top Doctor in America® annually, one among the top 5% of doctors in the U.S.
License: ME 78893
Reproductive Endocrinologist. Mark P. Trolice is the Director of Fertility CARE – The IVF Center and Clinical Associate Professor in the Department of Obstetrics & Gynecology (OB/GYN) at the University of Central Florida College of Medicine. He is Board-certified in REI and OB/GYN, and maintains annual recertification. His colleagues select him as Top Doctor in America® annually, one among the top 5% of doctors in the U.S. License: ME 78893.
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