What Do Ovarian Reserve Test Results Mean? (And Can I Improve Them?)

“Ovarian reserve” is a term that’s used in the fertility world to help evaluate a woman’s egg count and how she will respond to fertility treatment. It’s measured using three parameters:

1. Anti-Mullerian hormone levels. AMH is secreted by cells that surround the ovarian follicle, a fluid-filled sac where an egg matures and is eventually released from during ovulation.
2. Antral follicle count, which is the number of follicles (with a diameter of 2 to 10 millimeters) present; they’re counted via an ultrasound.
3. Follicle-stimulating hormone and estradiol levels on day three of the menstrual cycle. FSH, as its name suggests, stimulates the ovaries to grow a follicle, and the follicles produce estrogen. Measuring these hormones on day three—the beginning of the follicular phase—gives baseline measurements of these otherwise-fluctuating hormones.

Each of these parameters helps give perspective on how many eggs (or oocytes) a woman potentially has, because there’s no way to measure that directly. Using these values, fertility doctors can estimate how a woman will respond to fertility treatment.

But those numbers aren’t the entire picture—there’s still so much that’s unknown about fertility and conception. “I’ve seen patients with normal AMH and follicle counts still have difficulty conceiving,” says Anu Kathiresan, MD, a board-certified reproductive endocrinologist and ob-gyn at Kindbody. It’s called unexplained infertility. “I’ve also seen women with low AMH and follicle counts conceive.”

If you’re trying to get pregnant without fertility assistance, ovarian reserve measurements are not the best indicator. “There isn’t evidence to show a link toward chances of conceiving naturally and ovarian reserve parameters,” she says.

Can you increase your ovarian reserve? Unfortunately, no, Kathiresan says—it’s not possible from a biological perspective. We’re born with a certain number of eggs, and we don’t generate more. But there are things we can do to help optimize the eggs we currently have.

• Maintain a balanced diet. Kathiresan says that the key is trying to optimize your diet as much as possible. “We usually recommend a Mediterranean diet and to avoid red meats, excess sugars, and processed foods,” she says.
• Be physically active. She says there are no strict recommendations here. Generally, getting in good cardio and intermittent weight lifting is great. “We don’t want it to be too excessive—but also not too light,” says Kathiresan. “Just try to have a healthy balance.”
• Take supplements. “There are supplements we recommend,” Kathiresan says. “They don’t dramatically change egg quality, but they can help a little bit.” These include CoQ10 (about 200 milligrams three times a day) and DHEA (25 milligrams three times a day). She says it’s also important to take a daily prenatal vitamin with at least 400 milligrams of folic acid and 500 to 1,000 milligrams of DHA when trying to conceive.
• Limit (and avoid) certain substances. “Try to avoid smoking and drugs and minimize alcohol,” Kathiresan says. They can have a negative impact on egg quality.

Depending on your vision for your future, egg freezing—extracting and freezing ovarian eggs for potential future pregnancies—may be a good option. “See where your numbers are and empower yourself with that information,” says Kathiresan. “Usually we would say that 30 to 35 is an ideal age range for considering egg freezing.” But she says there are no strict guidelines around this—women younger and older are still potential candidates. “We go through the pros and cons with each individual patient and let them take some time and see what path feels right for them.”

This article is for informational purposes only, even if and regardless of whether it features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. The views expressed in this article are the views of the expert and do not necessarily represent the views of goop.