Ovarian Reserve Explained: Egg Count, Testing, and What It Means for Your Fertility

In short: Ovarian reserve is the number of eggs remaining in the ovaries and an important indicator of a woman’s ability to conceive. A girl is born with a fixed number of eggs that is not renewed; it falls until the menopause, faster with heredity, smoking, ovarian surgery and chemotherapy. It is measured by AMH, FSH and ultrasound. No treatment is proven to increase the number of eggs.

Ovarian reserve refers to the number of eggs remaining in a woman’s ovaries, and it plays a key role in reflecting her natural reproductive capacity.

Is ovarian reserve renewable?

No. A woman is born with a fixed number of eggs. From puberty (the start of menstruation) onward, a certain number of these eggs are used up every month until the reserve is fully depleted, usually around age 50. At this point, a woman enters menopause and naturally loses her ability to conceive.

Is there a way to increase ovarian reserve?

No, there is currently no medical treatment that can increase the number of eggs in the ovary.

Does the rate of ovarian reserve decline vary from one woman to another?

Yes, it does — which is why the age at which women reach menopause can differ quite a bit from person to person.

What factors influence the rate of ovarian reserve decline?

• Genetic factors
• Smoking
• Ovarian surgeries that reduce ovarian reserve
• Some treatments such as radiation or chemotherapy for cancer patients
• Some chromosomal disorders such as Turner syndrome

Do vitamins help increase ovarian reserve?

No. Some supplements are promoted to improve egg quality, but so far there is no strong evidence that they increase the chance of pregnancy; the exception is folic acid, which every woman trying to conceive should take to protect the baby.

Can stem cell technology be used to increase ovarian reserve?

This approach is still under research and has not yet been officially applied in human treatment.

What tests are used to assess ovarian reserve?

• Ovarian reserve blood test (AMH)
• Evaluation of the number of eggs visible on ultrasound (antral follicle count)
• Evaluation of ovarian size on ultrasound (less accurate and no longer recommended as a main test)
• FSH hormone test on the second or third day of the menstrual cycle (less reliable than AMH and antral follicle count, as it varies from cycle to cycle)

It is important to know that these tests mainly predict how many eggs the ovaries will produce with IVF stimulation; they do not accurately predict the chance of natural pregnancy, so a low AMH does not mean that a woman cannot conceive, although it may mean she should not delay seeking treatment.

Can birth control pills help stabilize ovarian reserve and slow its decline?

No. Although birth control pills prevent ovulation, they do not preserve the ovarian reserve — a certain number of eggs are naturally lost from the ovary each month, whether ovulation occurs or not.

What options are available for a woman who wants to have children but has lost her ovarian reserve at an early age?

Egg donation may be considered, although this option is restricted or prohibited in many countries for religious or legal reasons.

What are the consequences of losing ovarian reserve?

A decline in the female hormone (estrogen), which can lead to menopausal symptoms, along with a loss of natural reproductive ability.

If you have concerns about your ovarian reserve or fertility, Dr. Najeeb Layyous and his team are available to guide you through appropriate testing and discuss your options with care and clarity.

Dr Najeeb Layyous F.R.C.O.G

Consultant Obstetrician, Gynecologist and Infertility Specialist