Ovarian reserve is the number of eggs in a woman’s ovaries. This number is an important part of a fertility evaluation and helps us decide what treatments may help. We measure ovarian reserve with blood tests and transvaginal ultrasounds.
Anti-Müllerian hormone test
The anti-Müllerian hormone (AMH) test is the most used fertility test for women. It measures blood levels of AMH, a hormone that corresponds to your egg count. A higher AMH level usually means a larger remaining egg supply, and a lower AMH level may mean you have fewer eggs left or your ovaries are getting older.
Follicle-stimulating hormone and estrogen (estradiol) test
Follicle-stimulating hormone (FSH) and estrogen tests are blood tests that are often used together to check your ovarian function. This test is usually done around the third day of your menstrual cycle. Higher levels of these hormones mean the ovaries are working harder and may mean smaller egg supply.
Transvaginal ultrasounds
Transvaginal ultrasounds look at your ovaries in order to count your follicles (sacs that hold your eggs). This type of ultrasound is done with a wand inserted in the vagina. The number of follicles is called the antral follicle count. A higher count usually means more available eggs.
A sonohysterogram is an ultrasound exam that lets your doctor see inside your uterus. During this procedure, they expand your uterus slightly to check for polyps, fibroids, scar tissue or any other issue that might affect fertility.
- A thin, soft tube (called a catheter) is placed in the uterus through your cervix.
- A small amount of fluid (called saline) is inserted into your uterus.
- An ultrasound is used to see the expanded uterus more clearly.
This test is quick, and you may have some mild cramping.
A hysteroscopy is another way your care team can get a clear look at your uterus. Your doctor will place a thin telescope with a camera through your cervix and into the uterus.
- Can be used to find issues inside the uterus, similar to transvaginal ultrasound and sonohysterogram
- May be used to treat a condition in the uterus found by other tests
- When used for diagnosis, a hysteroscopy is typically done in the UNC Fertility clinic, not a surgical space.
A laparoscopy is a minor surgery that lets your care team check your pelvic and abdominal organs, including:
- Fallopian tubes
- Uterus
- Ovaries
A small cut is made in the abdomen, and your doctor uses a thin telescope with a camera to look for uterine fibroids, ovarian cysts, blockages in the fallopian tubes and endometriosis.
Because this procedure is a minimally invasive surgery (using a small cut rather than a large incision), you typically go home on the same day of your surgery and can be back to normal activities within 1 to 2 weeks.
A hysterosalpingogram (HSG) is an X-ray exam that allows your care team to check the inside of your uterus and the fallopian tubes. They’re looking to see if the tubes are open and if the uterus has a healthy shape.
- Uses iodine-containing fluid, which looks white on the ultrasound
- Shows the shape of the uterus and whether fluid can move into the tubes
HSG cannot check the ovaries, show uterine fibroids on the outer lining of the uterus or show if you’ve got endometriosis. This test is usually short, and you may feel some pressure and cramping.