What is ovarian reserve function? It refers to the ability of the ovaries to produce normal eggs, which is determined by the number and quality of ovarian follicles. The more primordial follicles in the ovaries, the better the ovarian reserve function. During the reproductive period, women develop a batch of follicles every month, of which only one dominant follicle releases an egg, while the rest of the follicles develop to a certain extent and then regress on their own.
As the follicles decrease, the ovarian reserve function declines continuously, and fertility gradually decreases. How can we evaluate our ovarian reserve function?
When evaluating ovarian reserve function, it is recommended to start from the following aspects:
1. Age
Age is an important indicator of fertility capability. The older a person gets, the lower their fertility level. Especially for women after the age of 35, there is a rapid decline in follicle number, a decrease in egg cell quality, and the occurrence of abnormal egg cell nuclei. After the age of 38, the rate of follicle closure accelerates, showing a situation of “low pregnancy rate, low delivery rate, and high miscarriage rate.” Due to individual differences, age cannot be directly used as a sole indicator to judge ovarian function.
2. Sex hormone levels
Measure basal hormone levels on days 2-5 of the menstrual cycle, where an elevated basal FSH level indicates a decline in ovarian reserve function. Generally, FSH < 10 IU/L is considered normal and may indicate normal ovarian response; FSH > 10-15 IU/L suggests a low ovarian response; FSH > 20 IU/L indicates a hidden period of premature ovarian failure, potentially leading to amenorrhea.
Basal FSH levels may fluctuate in different menstrual cycles, so it is advisable to recheck. A significant fluctuation suggests a possible decline in ovarian reserve function. The FSH/LH ratio also reflects the level of ovarian function. An elevated FSH/LH ratio indicates a possible decline in ovarian function; if FSH/LH > 2-3.6, even with a normal basal FSH level, a relatively low LH suggests a decrease in ovarian reserve, leading to a low response during ovulation induction.
3. Basal inhibin B
Measure the level of inhibin B (INHB) between days 2-5 of the menstrual cycle to determine the basal INHB value. INHB < 45 pg/ml suggests a reduction in antral follicle count and a decline in ovarian reserve function. Compared to FSH, INHB more directly reflects ovarian reserve.
4. Anti-Müllerian hormone
Anti-Müllerian hormone (AMH) regulates the growth and development of follicles and has a relatively stable level, making it measurable at any stage of the menstrual cycle. A basal AMH < 1.26 μg/L highly indicates a decrease in ovarian reserve function. AMH is more accurate than FSH, AFC, and INHB in reflecting the decline of ovarian reproductive function.
5. Ultrasound examination
During the early follicular phase, ovarian volume and antral follicle count (AFC) can be evaluated through ultrasound to assess ovarian reserve function. Generally, a smaller ovarian volume in the baseline state (days 2-3 of the menstrual cycle), along with a decrease in original antral follicles and a small number of follicle growth, is associated with poor ovarian reserve if AFC ≤ 5.
These ovarian reserve indicators not only predict future fertility but also correlate with the success rates of ovulation induction, artificial insemination, and in vitro fertilization. Poor ovarian reserve not only lowers the chances of natural pregnancy but also significantly reduces the success rate of assisted reproduction.
How can ovarian function be improved?
Properly increase nutrition by consuming more vegetables and fruits rich in vitamins and trace elements, and including adequate amounts of meat and milk to ensure a balanced diet. This helps maintain hormonal balance and thereby improves ovarian function.
