Each woman is born with a set number of eggs predetermined before birth. This pool of eggs is never replenished. A female fetus has the greatest number of eggs at around 15-20 weeks of pregnancy (6-7 million). At birth, this number decreases to about 2 million, and by puberty to 300,000. This constant and dramatic process of decline continues until menopause. From the reservoir of eggs, fewer than 500 eggs will ovulate during a woman’s reproductive years.
Lower pregnancy rates and higher miscarriage rates are both a consequence of the aging process and reflective of the decline in egg quality. Neither fertility medications nor lifestyle changes can halt this.
In addition to using age to determine pregnancy chances, we use hormonal testing to obtain better insight into the quantity and quality of eggs. The first of these tests is basal FSH (follicle stimulating hormone) and estradiol. This blood test is performed on the second, third, or fourth day of the menstrual cycle. In general, values above 10 for FSH and 70 pg/mL for estradiol are considered elevated. Elevation of either one of these values bodes a potential decrease in pregnancy chances.
For some patients, we recommend a clomiphene citrate challenge test (CCCT), which is a more sensitive test for assessing ovarian reserve. This test, assesses FSH and estradiol values on day 3 followed by administering Clomid (clomiphene citrate 100 mg per day) from cycle days 5-9. We then assess FSH on day 10. Sometimes ordering an antimullerian hormone (AMH) to evaluate egg quantity is necessary.
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1800 Mistletoe Blvd.
Fort Worth, TX 76104 USA
Fort Worth Fertility serves the communities of Fort Worth, Dallas, Arlington, Grand Prairie, Haltom City, Richland Hills, North Richland Hills, Southlake, Lewisville, Mesquite, Grapevine, Abilene, Weatherford, Stephenville, Keller, Denton, Waco, Grandbury, Burleson, Crowley, Cleburne, Mansfield, Benbrook, Mineral Wells, Glen Rose, Hurst, Bedford, Azle, Lake Worth, Colleyville, Euless and Decatur.