Advanced Fertility Center of Chicago ivf

Ovarian reserve fertility tests - evaluation of egg quantity and quality

Female age is a very important consideration when estimating the probability for conception because it is a strong determinant of egg quality.

  • A 45 year old can have good quality eggs (for her age) and still be fertile, although this is rare
  • At the other extreme, a 25 year old can have very poor quality eggs and be infertile
  • These are extreme examples. The point is that egg quantity and quality declines - beginning in the early 30s and faster in the late 30's and early 40s.
  • Egg quantity and quality in a woman can be average for her age, better than average, or worse than average

It would be nice to have a reliable test to determine how many eggs remain and how good the eggs are in an individual woman at a point in time. We have some screening tests but they are not perfect.

  • These tests are often referred to as tests of "ovarian reserve"
  • We are testing the supply (or reserve) of eggs remaining in the ovaries

Do ovarian reserve tests check egg quantity, quality, or both?

  • Ovarian reserve testing can tell us quite a lot about the remaining quantity of eggs a woman has, but it tells us little about the quality of those eggs.
  • Age is the best "test" that we have at this time for egg quality

Egg quality and quantity and effect on success with fertility treatment

Testing fertility potential in women in the general population

Antral follicle count test

Counting the number of 2-9mm diameter antral follicles that can be seen with transvaginal ultrasound gives us a good idea about a woman's ovarian reserve.

More about antral follicle count testing

Day 3 FSH (follicle stimulating hormone) and estradiol (E2) test

By measuring a baseline FSH on day 3 of the cycle, we sometimes get an indication that the women is closer to menopause and has relatively less "ovarian reserve". In other words, if the day 3 FSH is elevated the egg quantity is reduced.

More about day 3 FSH and estradiol testing

More about premature menopause

Clomiphene challenge test

A clomiphene challenge test is a dynamic type of test that can discover some cases of poor ovarian reserve that are still showing a normal day 3 FSH. This test is discussed on the day 3 FSH page.

Anti-Mullerian hormone levels, AMH

Blood levels of the hormone AMH are often used by fertility specialists and gynecologists as part of the evaluation of ovarian reserve.

Response of the ovaries to ovarian stimulation with injectable gonadotropins (FSH)

This is not really a "test" that we do to help us determine egg quantity and quality - it is part of a treatment for infertility. However, the response of the ovaries when the woman takes injectable FSH for stimulation is often very predictive of the egg quantity - and therefore, also the relative chances for success with infertility treatment.

In vitro fertilization

This is a treatment for infertility, but at the same time it can give us much useful information about egg and embryo quality. By careful examination of the eggs and embryos during the in vitro incubation process we sometimes get clues about why pregnancy has not occurred previously.

For example, the eggs may demonstrate poor morphology, or may have problems with maturation, or with fertilization, proper cleavage, etc.

Treatment options for women with reduced ovarian reserve:

In vitro fertilization
Lupron "flare" protocol for ovarian stimulation in low responders
In vitro fertilization with assisted hatching
In vitro fertilization with donor eggs

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Chicago, IL 60630

Phone: (773) 794-1818
Fax: (773) 794-1819

30 Tower Court
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Gurnee, IL 60031

Phone: (847) 662-1818
Fax: (847) 662-3001

820 E. Terra Cotta Ave (Rte 176)
Suite 118
Crystal Lake, IL 60014

Phone: (815) 356-1818
Fax: (815) 356-1866



I am so grateful for Advanced Fertility Center. I just had my son Leland. I want to thank Dr. Catenacci and all of the nurses that helped us. Especially Ashley in the Crystal Lake office. You made this process easier by being supportive and positive. Thank you very much!


Dr. Sherban and his staff are the most amazing, compassionate, and supportive people. After almost 5 years of trying to conceive, going through numerous tests and meeting with another clinic closer to home, who told me my chances even with IVF were still very low, a good friend recommended advanced fertility center of Chicago. Best decision we ever made! We now have 2 amazing children who are now 5 and 3 years old! I cannot stress enough how amazing this staff is, they make you feel like family!


Our experience was amazing with Dr. Cantanucci and all of the nurses (especially Ashley). After ttc for 4 years and at 41 years of age, we became pregnant after 1 round of IVF, and had our beautiful boy this past October. Can't thank them enough!


2/7/15 our son was born all thanks to the assistance of Dr. Sherbahn and his staff. Everyone was so helpful and here for all our questions, worries, etc. They want this for you just as much as you want this for you! Handled with pure professionalism and care from the very start! Thank you advanced fertility!