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Dan C. Martin, MD
UT Medical Group, Inc.

University of Tennessee Health Science Center (UTHSC)

UTHSC Academic Office

Daniel Clyde Martin, M.D.
UT Medical Group, Inc.
Infertility and Gynecology
Reproductive Surgery
Germantown Office Building
7945 Wolf River Boulevard
Suite 320
Germantown, Tennessee
TN 38138-1733

(901) 347-8331
(901) 347-8188 fax
Directions to Office

Updated information is at
UTMG 2006

Click for information on:
Glenn Ann Martin, Ph.D.
Clinical Psychologist

 

Testing of Ovarian Aging

 

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Fertility Related Pages
[Infertility] [Evaluation] [Clomiphene] [Intrauterine Insemination] [PCOS]

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Blood tests for follicle stimulating hormone (FSH), Estradiol (E2) and Anti-Mullerian Hormone (AMH) can be used to check ovarian reserves and adequate egg function. A sonographic antral follicle count gives similar information.  See links below for more complete information.

When these tests are abnormal, fertility decreases and the chance of miscarriage increases. These tests may be most useful in women over 40 as a guide for IVF, but can be used in younger women to give an estimate of egg reserves.

The FSH and E2 are done on day 3 (day 2 to 4) of a menstrual cycle. 

The AMH can be done at any tine during a cycle.

An antral follicle count is done day 2 to 5 of a cycle.

Resources

Advanced Fertility Center of Chicago
   Day 3 Testing of FSH and E2
  
http://www.advancedfertility.com/day3fsh.htm
   Anti-Mullerian Hormone (AMH)
  
http://www.advancedfertility.com/amh-fertility-test.htm
   Antral Follicle Count
  
http://www.advancedfertility.com/antralfollicles.htm

International Premature Ovarian Failure Association, Inc. (IPOFA)
www.pofsupport.org.

Department of Health and Human Services (HHS)
http://www.womenshealth.gov/menopause/early-premature-menopause/

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Research studies demonstrate:

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Absolute levels vary.

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Healthy day 3 FSH levels are generally less than 10. 

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Values of 10 to 18 are generally intermediate and are sometimes associated with lower fertility and higher miscarriage rates. 

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Pregnancies are rare and miscarriages increase with high FSH values more than 18.  The clinical name for this is diminished ovarian reserve (DOR).  Miscarriage rates were 57% at age 35 and 90% at age 40 with DOR in  one study.

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Live births have generally occurred when the day 3 FSH is less than 14, the estradiol less than 81, and the age less than 43 years. 

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DOR can be treated treated with donor eggs.

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References

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Buyalos RP; Daneshmand S; and Brzechffa PR.  Basal estradiol and follicle-stimulating hormone predict fecundity in women of advanced reproductive age undergoing ovulation induction therapy.  Fertil Steril 68:272-277, 1997

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Check JH, Check ML, Katsoff D. Three pregnancies despite elevated serum FSH and age. Human Reprod 2000

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Corson SL.  The simple screen can predict ART failure.  Ob/Gyn Management, pages 30-34, October, 1998.

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Levi AJ; Raynault MF; Bergh PA; Drews M R; Miller BT; Scott RT. Reproductive outcome in patients with diminished ovarian reserve. Fertil Steril. 76: 666-669, 2001.

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Trout SW; Seifer DB.  Do women with unexplained recurrent pregnancy loss have higher day 3 serum FSH and estradiol values? Fertil Steril 74: 335-337, 2000.

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