How to tell your ovaries are working!

If I had an office visit FAQ, this would be at the top. Women – all ages, all sorts of relationships, all phases of their reproductive lives – want to know how their ovaries are doing. They want hormone tests. They want ultrasounds. They want it all.

Should you want it all too? Moreover, do you need it?

Should you have an evaluation to see how your ovaries work?

Yes, IF:

• you are trying to get pregnant, you are younger than 35, and it’s been a year (why? Read my post specifically about this)
• you are trying to get pregnant, you are 35 or older, and it’s been 6 months (remember this post?)
• you’ve had surgery on your ovaries (examples: had a cyst removed, had one of your ovaries removed) and you’re trying to get pregnant

Do you see a trend yet?  We usually do these tests when you’re trying to get pregnant and aren’t successful for some reason.

Moving on … 

Yes, IF:

• you have symptoms of menopause when you’re too young for menopause  (hot flashes, vaginal dryness)
• you have irregular periods – this may be an early indicator of some ovarian dysfunction, so yes, we want to see how your ovaries are doing.

What are the tests?

Hormone tests (3 of them!)

• Estradiol – a form of estrogen
• Follicle Stimulating Hormone

These 2 blood tests need to be drawn on a specific day of your menstrual cycle. Day #3 to be exact (the first day of your period is Day #1). There’s the normal range, a gray zone, and a menopausal level too.

• Anti-Mullerian Hormone

A fancy name for a fancy hormone. It’s an indicator of how well your ovaries may respond to stimulation (like injectable hormones for IVF). Low is bad. High is good. It doesn’t change with your menstrual cycle so it can be drawn on any day.

Ultrasound:

• Antral Follice Count

An ultrasound on a specific day of your menstrual cycle. You guessed it, Day #3. We look at your ovaries with the ultrasound and count your follicles. 10 or more is good. 4 or less is bad.

What do these tests actually test?

They look at your ovarian reserve, which is the number and quality of oocytes, … which is the fancy term for “how your ovaries are doing”. The results don’t predict fertility. If they are abnormal it does not mean you can’t get pregnant, but it may tell you your ovaries are not as robust as they used to be. And it may mean you don’t respond to fertility treatment (like IVF). An abnormal test says “don’t wait” I refer to fertility specialists all the time for this! Don’t fiddle around for another year crossing your fingers that you’ll get pregnant.

So now that you know what tests you need, you can go demand them from your doctor. We love it when you do that.