Ovarian Reserve Testing
- Antral follicle count
- ( AMH)Anti-mullerian hormone
- Basal FSH levels
AFC ( ANTRAL FOLLICLE COUNT)
ANTRAL FOLLICLES are SMALL IMMATURE FOLLICLES in the ovaries measuring 2- 9 mm. antral follicle count is measured by transvaginal ultrasonography between day 2 to day 3 of the menstrual cycle. The numbers of follicles in both ovaries are added for the total AFC.
A count of more than 10 follicles is considered normal. Assessment of AFC is a low cost and effective method of assessing ovarian reserve .
AMH( anti-mullerian hormone)
Anti-Mullerian hormone (AMH) is exclusively produced by granulosa cells of preantral (primary and secondary) and small antral follicles (AFs) in the ovary. The production of AMH starts following follicular transition from the primordial to the primary stage, and it continues until the follicles reach the antral stages, with diameters of 2-6 mm.The number of the small AFs is related to the size of the primordial follicle pool.
The number of the antral follicles decrease with age and hence AMH production appears to decrease and become undetectable at and after menopause . AMH levels strongly correlate with basal antral follicle count (AFC) measured by transvaginal ultrasonography.
BASAL FSH LEVELS
Follicle stimulating hormone (FSH) is a reproductive hormone . It is measured on day 2to day 3 of the menstrual cycle. It is the most widely used ovarian reserve test to assess the ovarian reserve, and response to stimulation. An increase in FSH levels occurs due to follicle depletion and decreased ovarian reserve.
The measurement of FSH is easy, and inexpensive and provides a valuable information in the assessment and management of infertile woman.
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