Ovarian Reserve Tests Fail to Predict Fertility, Study Suggests

Tests that estimate ovarian reserve, or the number of a woman’s remaining eggs, before menopause, do not appear to predict short-term chances of conception, according to an NIH-funded study of women with no history of infertility. The study appeared in the Journal of the American Medical Association.

“Women are born with a set number of eggs that gradually declines through the reproductive years,” said Dr. Esther Eisenberg of NICHD’s Fertility and Infertility Branch, which funded the study. “This study suggests that testing for biomarkers of ovarian reserve does not predict the chances for conception in older women still of reproductive age.”

As a woman ages and her egg supply declines, cells in the ovary secrete lower amounts of inhibin B and anti-Müllerian hormone, substances considered to be indicators of ovarian reserve. The ovaries also produce higher amounts of follicle stimulating hormone (FSH) in the days before ovulation. 

Although there is little research to support their use, tests for anti-Müllerian hormone are routinely offered in many fertility clinics on the assumption that women with a lower ovarian reserve would be less likely to respond to treatment. Moreover, home fertility tests of urinary FSH are commercially available.

“Our study suggests that younger women with biomarker levels indicating lower ovarian reserve should not become anxious that they won’t be able to have a baby,” said Dr. Anne Steiner, first author of the study and professor of reproductive endocrinology and infertility at the University of North Carolina at Chapel Hill.