Ovarian reserve is an essential concept when talking about fertility and family planning. This reserve represents the quantity and quality of eggs available in the ovaries throughout the reproductive life. As time goes on, the ovarian reserve shrinks, which can influence the chances of conceiving. To understand ovarian reserve, it is essential to know the hormones that affect it and how they provide information about reproductive health.
Analysing the hormones that determine ovarian reserve is key to predicting fertility problems and making decisions in time. These hormonal markers allow health professionals to assess reproductive status and suggest personalized strategies based on each situation.
Anti-Müllerian hormone (AMH)
Anti-Müllerian hormone (AMH) is one of the main indicators of ovarian reserve. It is a hormone produced by the developing follicles within the ovaries, especially those that are in the early stages of growth. AMH levels reflect how many follicles are available in the ovaries, giving an idea of the number of potentially usable eggs.
- AMH values: Generally, a high AMH level indicates a good ovarian reserve, while low values can suggest a decrease in the number of eggs available. AMH is usually stable throughout the menstrual cycle, making it easy to assess at any time of the month.
Follicle-Stimulating Hormone (FSH)
Follicle-stimulating hormone (FSH) also plays a crucial role in determining ovarian reserve. It is responsible for stimulating the growth of follicles in the ovaries and its production increases when the ovarian reserve is low.
- FSH and its relationship to ovarian reserve: When there are fewer eggs in the ovaries, the body tends to produce more FSH to try to stimulate follicular growth. For this reason, elevated FSH levels, especially at the start of the menstrual cycle day 3 to 5, can be a sign that the ovarian reserve is decreasing.
Estradiol
Estradiol is a hormone of the estrogen group, produced mainly in the ovaries. In addition to regulating the menstrual cycle and preparing the body for a possible pregnancy, estradiol can offer information about ovarian reserve when measured in combination with FSH.
- Estradiol levels in fertility: A high estradiol level at the beginning of the menstrual cycle, along with high FSH levels, may indicate a low ovarian reserve. Although this hormone alone does not determine the number of eggs, its evaluation along with other markers offers a more complete view of reproductive status.
Luteinizing Hormone (LH)
Luteinizing hormone (LH) is another important hormone in the context of ovarian reserve. It is involved in regulating the menstrual cycle and ovulation, and its levels are used to assess the overall functioning of the ovaries.
- LH and ovulation: Although LH does not directly measure the number of eggs, its relationship to FSH and estradiol allows for information about overall hormonal health and the body’s ability to ovulate properly.
Inhibin B
Inhibin B is a hormone produced by ovarian follicles, especially in the early stages of follicular development. Its main function is to inhibit the production of FSH, helping to regulate its level in the body.
- Inhibin B and ovarian reserve: Low levels of inhibin B may indicate a lower number of follicles available in the ovaries. For this reason, this hormone is used in some fertility tests to evaluate the ovarian reserve and predict the response to ovarian stimulation treatments.
How is the ovarian reserve assessment performed?
The evaluation of the ovarian reserve combines several hormonal tests with imaging tests. Hormone tests are usually done at the beginning of the menstrual cycle, as at that time the values give a more accurate picture of the condition of the ovaries. In addition to the measurement of AMH, FSH, estradiol, LH, and inhibin B, transvaginal ultrasound is a common method of counting antral follicles, another visual indication of ovarian reserve.
The joint analysis of these factors allows health professionals to obtain a clear view of fertility and plan possible assisted reproduction treatments or recommendations for egg preservation.
What factors can affect hormones related to ovarian reserve?
Hormones do not work in isolation. There are several factors that can influence its levels and, therefore, the interpretation of the ovarian reserve:
- Age: The ovarian reserve naturally decreases with age, especially after the age of 35. This affects both AMH and FSH levels and other related hormones.
- Hormonal disorders: Conditions such as polycystic ovary syndrome (PCOS) can significantly alter hormone levels, increasing AMH and affecting the balance of other hormones.
- Lifestyle habits: Smoking, excessive alcohol consumption, and stress can have a negative impact on hormonal health and ovarian reserve.
- Medical treatments: Some treatments, such as chemotherapy or radiation therapy, can affect the ovarian reserve, reducing the number of eggs available and altering hormone levels.
Knowing what the ovarian reserve is offers an advantage for family planning, since it allows informed decisions to be made in advance. Many people choose to know these values before trying to conceive, especially if they are considering fertility treatments or if they want to preserve their eggs for the future.
In addition, the evaluation of these hormones can help identify problems before they become a hindrance, making it easier to find solutions and increasing the chances of success in a fertility treatment.
At Fertivida, we have specialists who provide personalized advice and support to better understand the hormonal status and offer the best options at each stage of reproductive life.
