Wednesday, August 15, 2018

The limitation of testing for ovarian reserve

The chances of getting pregnant after IVF depend on the quality of the embryos, and the quality of embryos depends on the quality of the eggs. This is why testing for ovarian function is extremely important before doing an IVF cycle. We know that patients who have better ovarian function have a higher chance of getting pregnant, which is why measuring antral follicle count, as well as the AMH level, is so important.
However, we need to understand the limitations of these tests. Thus, there are patients with low AMH levels who do get pregnant after IVF – and there are patients with normal AMH level who has a poor ovarian response.
While the quantity and quality of eggs usually go hand in hand, this correlation often breaks down.
This is because the quality of the embryo is determined by the energy which the mitochondria in the cytoplasm of the egg can provide, and this is not something we can measure based  on either an AMH level or an antral follicle count.
Sadly, there is no test as yet which allows us to assess the mitochondrial competence of the egg, and this is why an IVF cycle gives us information as regards egg quality which nothing else can as yet. How good the quality of the embryos is tells us far more about the quality of the eggs as compared to any other test !
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