The 3 Most Important Hormones for Assessing Ovarian Reserve
January 21, 2020 | Yesmom
If you are having trouble getting pregnant or considering undergoing fertility treatments, you will be required to run some fertility tests to have some of your hormones assessed to see how your ovarian reserve is doing. You may have already Googled about these tests or asked your doctor about them, but all that information can get quite overwhelming and leave you totally confused about the world of hormones.
Here we simplify for you what you need to know about the hormones used to measure ovarian reserve and fertility potential. They are the Anti-mullerian hormone (AMH), Follicle-stimulating hormone (FSH), and Estradiol (E2).
Anti-Mullerian Hormone: The key to ovarian reserve
Anti-Mullerian hormone (AMH) is secreted by the developing egg follicles in the ovaries. AMH level reduces naturally as you age, so it is considered an important marker of ovarian reserve. Having AMH tested helps measure how many follicles are left in the ovaries, however, this test does not reveal the quality of these follicles.
Low AMH levels are considered a sign of low ovarian reserve, as it means there is a lesser number of follicles secreting AMH. While excessive follicles elevate AMH levels, high AMH levels can indicate Polycystic Ovarian Syndrome (PCOS), a medical condition that can negatively impact fertility.
AMH level is also used to measure reproductive aging and considered to be a good predictor of a woman’s menopause timing. Lower than average ovarian reserve predicted by AMH level can be an indicator that a woman may reach menopause earlier than usual for her age. Even if she may reach menopause around 46 to 50 years of age, the effects of menopause can start to affect fertility as early as when she is 35. So if you are older than 35, it is important to assess and understand your fertility and menopause window.
AMH is tested using your blood samples. Since it has almost nothing to do with ovulation and does not vary during the cycle like the other hormones, it can be tested even when a woman is on contraceptive pills.
Follicle Stimulating Hormone
Follicle Stimulating Hormone (FSH) is responsible for pubertal development and for the proper functioning of the ovaries. It is required for maturation of the follicles and for initiating ovulation. For ovarian reserve, low levels of this hormone can suggest ovarian failure, as it affects maturation and release of eggs. High FSH levels are common in older women, as it decreases with advancing age. It also indicates a reduction in the production of estrogen and progesterone and the functioning of the ovaries.
FSH levels can be tested using blood and urine samples, though the test results may not be reliable if you are using birth control pills.
Estradiol (E2), produced by the ovaries and the adrenal glands, is required for the healthy functioning of sexual organs. This form of estrogen is vital for the development of sex organs such as breasts, vagina, uterus, and fallopian tubes. It naturally increases during the menstrual cycle to prompt the maturation and release of an egg. Its level peaks at the time of ovulation, falls continuingly, and remains low and stable during the menstruation period. To keep track of its level can, therefore, suggest about your ovarian reserve.
Another important role of estradiol is that it thickens the uterus’ lining in preparation for implantation of a fertilized egg. This lining is shed during menstruation if conception does not occur for the cycle to begin again.
Too much estradiol can cause acne, constipation, loss of libido, weight gain, and depression. It may also lead to infertility and increases the risk of uterine and breast cancer. Measuring estradiol levels in the blood helps evaluate how well the ovaries function.
Final Note on Ovarian Reserve Test
Ovarian reserve testing is the bread and butter of testing fertility and a crucial piece of the fertility puzzle. AMH is the most important hormone to be measured if you want to know your ovarian reserve and menopause timing. It is also crucial as a part of your fertility treatment journey. However, if you want a more complete picture of your fertility, it is best to have your FSH and E2 tested as well.
- Anti-Müllerian Hormone Test [Internet]. 2019 March 12. Available from https://medlineplus.gov/lab-tests/anti-mullerian-hormone-test/
- Follicle-stimulating hormone (FSH) blood test [Internet]. 2017 July 7. Available from https://medlineplus.gov/ency/article/003710.htm
- What are the Functions of Follicle-stimulating Hormones (FSH) and Luteinizing Hormones (LH) in the Female Reproductive System? [Internet]. 2018 March 12. Available from https://www.medscape.com/answers/118810-91040/what-are-the-functions-of-follicle-stimulating-hormones-fsh-and-luteinizing-hormones-lh-in-the-female-reproductive-system
- Anti-Müllerian Hormone [Internet]. 2018 March]. Available from https://www.yourhormones.info/hormones/anti-muellerian-hormone/
- Krishnarajabhatt HS, Muraleedharan A, Narayan P, Unnikrishnan P. An Ayurvedic treatment protocol to improve anti-mullerian hormone: A prerequisite for assisted reproductive technique- A case report. An International Quarterly Journal of Research in Ayurveda. 2017:38(1-2);66-69.
- How Do I Know I’m in Menopause? [Internet]. Available from https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/how-do-i-know-i’m-in-menopause-
Estrogen Levels Test [Internet]. 2019 June 4. Available from https://medlineplus.gov/lab-tests/estrogen-levels-test/