Update on Assessment of Ovarian Reserve Testing

Abstract

ABSTRACT Importance Women are increasingly postponing pregnancy to achieve specific goals, and as it is known, the ovarian reserve (OR) declines with age, especially after the 30s. Assessing the OR helps in managing the care of women seeking pregnancy. Several OR tests (ORTs) have been advocated for assessing OR. Objectives This review aims to discuss the different ORTs and the consequences of their use. Evidence Acquisition For each topic, a PubMed search was conducted using MeSH terms. The following terms were used: ovarian reserve, ovarian reserve tests, anti-Müllerian hormone, antral follicle count, and diminished ovarian reserve. The search for further references was complemented by manual search, review, synthesis, and summarization of retrieved articles. Results In this review, we clarified the concept of OR and the different ORTs and provided a guide for the ultrasound to assess OR. In addition, the clinical value of ORTs was highlighted to explain the implications of the results of these tests and how they can aid in patient counseling. Conclusion and Relevance A number of ORTs are available to the clinician. Anti-Müllerian hormone and antral follicle count are the most valuable, but as with all ORTs, they are best used as screening, not diagnostic tests for OR. Screening for OR is most helpful when applied to specific groups. Target Audience Obstetricians and gynecologists, family physicians. Learning objectives After completing this activity, the learner will be better able to describe the different available ovarian reserve tests; discuss the indications of their use; and explain the different ultrasonic testing used for the assessment of ovarian reserve and how to interpret results.