Women: Ovarian Function

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Ovarian Function and Ovarian Reserve Screening

Ovarian disorders account for approximately 30-35% of female related infertility. Testing is aimed at giving us information on whether or not you are ovulating. If you are ovulating, these tests will show how well you ovulate and give a gauge for your egg quality. Some women may have regular, ovulatory periods, but the egg quality may still be reduced. This is a natural phenomenon.

Baseline Ultrasound

Performed on day 2, 3, or 4 of the cycle. Provides information on the overall size and volume of the ovaries as well as the antral follicle count (number of early immature eggs available per menstrual cycle) in the early part of the menstrual cycle, just after onset of the menstrual bleed.

Day 3 Blood Work (FSH, LH, E2)

By looking at hormone levels such as FSH (follicle stimulating hormone), LH (luteinizing hormone) and E2 (Estradiol) drawn at the beginning of the menstrual cycle (days 2, 3, or 4) Dr. Zoneraich will get a good indication of a woman’s “ovarian reserve.”

Is Day 3Testing Important?

Day 3 Blood Work is very important because gives Dr. Zoneraich key information about your reproductive potential. Ovarian reserve is a measure of how well the ovaries are expected to respond to stimulation with fertility medication. Since ovarian reserve begins to decline approximately 6-7 years prior to menopause (average age is 50-51) and the onset of menopause occurs earlier for some women, all women will be tested in order to provide appropriate counseling and determine which procedures and protocols would be of most benefit.

The “Day 3 hormone test” is a very sensitive test and provides us with a great deal of information which may impact your treatment. Since there can be quite a discrepancy in results between different laboratories, we require that this test be performed in our facility to assure accurate interpretation.

How Do I Know If It Is Day 3?

Day 3 is considered the 3rd day of the menstrual bleeding. Full flow of blood by 5pm is considered Day 1. Call the office as soon as you know it is Day 1 to schedule all of your testing! Do NOT wait until Day 3 to call!

Clomiphene Citrate Challenge Test (CCCT)

Changes that decrease a woman’s chances to reproduce may start many years before early menopause. These changes include but are not limited to decreases in the number of oocytes (eggs), as well as increased number of chromosomal abnormalities within the oocytes. While age itself is an important factor, not all women of the same age have the same reproductive potential. All women age 35 and over, as well as those who have a medical history suspicious for possible decreased ovarian reserve will be asked to undergo a CCCT. In order to complete the CCCT, blood is drawn on day 3 and 10 of the menstrual cycle (FSH, Estradiol, LH), while taking a medication called Clomiphene Citrate (100mg) on days 5, 6, 7, 8, 9 of her cycle. These tests must be performed by our own laboratory.

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