Medical Contribution by Naveed Khan, M.D. of Shady Grove Fertility’s Leesburg, VA office.
Egg supply, or ovarian reserve, is the number of potential eggs that remain in your ovaries and is closely linked to your ability to conceive. In general, the more eggs a woman has, the better her chance of getting pregnant, whether trying with her partner on their own or through fertility treatment.
As a woman ages, the number of eggs in her ovarian reserve continually declines. Women are born with all of the eggs they will ever have, generally around 1 to 2 million. By the time a woman reaches menopause, typically in her early to mid 50s, as many as a few hundred remain, potentially even less.
“I’m often asked by my colleagues in the OB/GYN community, as well as by my own patients, what is important to know about testing your egg supply,” says Naveed Khan, M.D. He goes on to explain, “Assessing the quantity of eggs remaining can help plan for pregnancy—whether you want to wait or start a family right away.” Here are 10 things you should know about your egg supply:
Factors that Impact Egg Supply
- Age is the biggest factor affecting egg supply. This is true for all women: the older you get, the fewer eggs you have. Your body does not produce more eggs, nor is there any available treatment to increase the quantity or quality of your egg supply.
- Other factors also affect the quantity and quality of eggs. While age is the most important factor, the quantity and quality of the eggs available is also affected by:
- early menopause
- aging chromosomes or premature aging of the ovaries
- health issues such as autoimmune disorders, cancer treatment, or surgery that involves the ovaries
Testing Egg Supply
- Ovarian reserve testing is a key part of an initial infertility evaluation. If you see a fertility specialist because you are having trouble conceiving, your doctor should include ovarian reserve testing in your evaluation. The American Society for Reproductive Medicine recommends seeing a fertility specialist if you are over age 35 and have been trying to conceive unsuccessfully for more than 6 months or are under age 35 and have been unable to conceive after 1 year. Women over age 40 who are having trouble conceiving should see a fertility specialist as soon as possible.
- You can ask your doctor to check your egg supply during a routine OB/GYN exam. Regardless of your age, you can request ovarian reserve testing during a regular, annual visit to your obstetrician/gynecologist. Testing can help younger women (those in their 20s and early 30s) who learn they have a lower egg supply to proactively plan for their future through egg freezing if they are not actively trying to conceive. Or a younger woman who learns she has a healthy and plentiful egg supply may use this information as a baseline to compare future tests.
- Most insurance plans cover ovarian reserve testing. Because egg testing is part of an infertility evaluation, most insurance companies will cover the cost. Coverage of fertility treatment will vary based on your insurance provider and plan. Check with your insurance provider to see what is covered.
- Currently there are three tests used to help determine the status of your ovarian reserve. Two of the tests are simple blood tests drawn on the third day of your cycle. Your doctor will use these tests to check the level of follicle-stimulating hormone (FSH) and anti-Müllerian hormone (AMH). The third test is a transvaginal ultrasound, also preformed on the third day of your cycle. This test allows your physician to count the number of small follicles in your ovaries. When evaluating your egg supply, your doctor should look at the results of these three tests together to get a complete picture of your ovarian reserve status.
Available Treatment and Resources
- Treatment is available for women with low ovarian reserve. Even with a decreased egg supply, there are successful treatments options available to help you conceive. In vitro fertilization (IVF) and donor egg are two options to consider. Your doctor will help you balance the least complex treatment option with the greatest chances of success.
- Egg freezing is now a reality for many women. For women whose ovarian reserve may be beginning to decline, or for those who are not planning on conceiving in the near future, egg freezing can help preserve future family building options. Advances in egg freezing technology have greatly increased success rates for getting pregnant by freezing, thawing, and fertilizing eggs.
- Time is of the essence. I tell my patients, and I encourage my OB/GYN colleagues to share with their patients as well—your treatment success depends on your age and the extent of the egg loss. If you get tested and find you have a low ovarian reserve, don’t wait to see a fertility specialist. The younger you are, the better your chances of success.
- Resources are available to help you be proactive about your fertility. Specialists at Shady Grove Fertility can help you plan for a successful pregnancy, whether you have a healthy or diminished egg supply. Start today and call 877-971-7755 to speak with a new patient liaison or to schedulean appointment with one of our physicians.
To learn more about testing your egg supplyor toschedulea new patient appointment, please call our New Patient Center at 877-971-7755.
FAQs
How do I check my egg supply? ›
The AMH Test
The level of AMH in a woman's blood helps doctors estimate the number of follicles in her ovaries; the more follicles a woman has, the more eggs she can release, and the better her chances of pregnancy.
Aging is one of the biggest causes of low ovarian reserve; however, sometimes, there is no cause. Other times, genetics or medical treatments cause diminished ovarian reserve. These include: Genetic disorders that affect the X chromosome.
How many follicles is normal at 35? ›On average, women in their mid 20s to early 30s have around 12 to 30 antral follicles, while women aged 35 to 40 may have between 8 and 15 and women aged 41 to 46 may have somewhere between four and 10.
How many eggs left at 30? ›For example, a woman at 30 often has around 100,000-150,000 eggs in reserve. By 35, that number is likely around 80,000. Late into the thirties, that number could be 25,000, 10,000, or fewer.
Can I check how many eggs I have left? ›There are two good ways to measure egg count: an antral follicle count and an AMH (anti-Müllerian hormone) test. During an antral follicle count, a doctor uses ultrasound to count the visible follicles. Each follicle contains an immature egg that could potentially mature and ovulate.
What age is low egg count for? ›The number of eggs decreases as women get older. At birth, most girls have about 2 million eggs, at adolescence that number has gone down to about 400, 000, at age 37 there remain about 25,000. By age 51 when women have their menopause they have about 1000 immature eggs but these are not fertile.
What lowers your egg count? ›- Cigarette smoking.
- Genetic abnormalities (Fragile X and other X chromosome abnormalities)
- Aggressive treatments (radiation for cancer)
- Ovarian surgery, such as endometriosis.
- Idiopathic (this means that there is no apparent cause)
Light triggers a hen's pituitary gland to produce eggs. Regular egg-laying requires 14 to 16 hours of light and decreased daylight hours in autumn and winter can cause egg production to decline or stop completely.
What can damage egg quality? ›Other than age, causes such as endometriosis, ovarian cysts, some immunological disorders, obesity, chemotherapy, drug use, smoking, alcohol and caffeine consumption may also lead to decreased egg quality.
Which food increase egg quality? ›The general advice for eating to achieve healthy eggs and sperm is to have a well-balanced diet which includes: Plenty of fruit and vegetables a day. Complex carbohydrates – whole grains like brown rice, oats and wholemeal bread. Organic foods where possible.
What percentage of eggs are normal by age? ›
...
Fertility statistics by age: egg count over time.
| Ages | Number of genetically abnormal embryos |
|---|---|
| 31-35 | 35% |
| 35-37 | 45% |
| 38-40 | 60% |
| 41-43 | 80% |
- Plenty of fruit and vegetables a day.
- Complex carbohydrates – whole grains like brown rice, oats and wholemeal bread.
- Organic foods where possible.
- Oily foods such as fish, nuts, seeds and oils.
- Avoid trans fats.