Testing and interpreting measures of ovarian reserve: a committee opinion

Markers of ovarian reserve can be useful as predictors of oocyte yield after controlled ovarian stimulation and oocyte retrieval. However, they are poor predictors of reproductive potential independently from age.

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VOLUME 114, ISSUE 6, P1151-1157


Practice Committee of the American Society for Reproductive Medicine


Ovarian reserve is defined as the number of oocytes remaining in the ovary, or oocyte quantity (oocyte number). Markers of ovarian reserve include hormone levels and sonographically measured features of the ovaries. These markers can be useful as predictors of oocyte yield following controlled ovarian stimulation and oocyte retrieval. However, they are poor predictors of reproductive potential independently from age. This document replaces the document of the same name last published in 2012 (Fertil Steril 2012;98:1407–15).

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

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Go to the profile of Luis Hoyos
4 months ago

This is a very thorough committee opinion describing the state of the art in regards to ovarian reserve testing. However, I would like to play devil's advocate for a second about the following statement "markers of ovarian reserve should not be used to promote planned oocyte cryopreservation. Decisions regarding oocyte cryopreservation should be based on a woman's reproductive plans and age." While I agree with the substance of the statement, I do think that the decision should actually include ovarian reserve testing in addition to reproductive plans and age. In a hypothetical example of a 28 year woman with diminished ovarian reserve by antral follicle count (to avoid possible AMH assay technical difficulties), the decision to promote oocyte cryopreservation would be very different if she wanted to delay child-bearing until age 35-37 and her ideal family size was >1 child vs. if she wanted to conceive within the next two years or if her ideal family was just one child even if she decides to wait until age 35. Therefore, I do think that ovarian reserve testing definitely provides some valuable information to be used in conjunction with the woman's reproductive plans and age. If her ideal family size is >1 child and she is sure about delaying conception past age 35, she is at risk of a double whammy by adding decreased oocyte quality to the mix and therefore, not having done oocyte cryopreservation at an earlier age would be a missed opportunity.