When you become an egg donor you will need to visit a fertility clinic for screening. The fertility doctor will want to know more about your ovarian reserve (potential egg supply) and how your body will respond to the medications they will give to stimulate egg maturation. This information helps the fertility doctor create a customized treatment plan gives you the best chance of a successful retrieval cycle. The information collected in your screening will also reduce the risk of you experiencing ovarian hyperstimulation syndrome (OHSS).
None of the tests you undergo will give an accurate picture of what the likelihood of success is or how to best treat you throughout your egg retrieval cycle. The fertility clinic will perform a series of tests to be assessed together, which may include:
- Anti-Mullerian Hormone (AMH) level
- The Antral Follicle Count (AFC)
- Follicle Stimulating Hormone (FSH) and Luteinising Hormone (LH)
Anti-Mullerian Hormone (AMH) Test
Anti-Mullerian Hormone is produced by the ovarian follicles that are developing in the ovaries. It is a good indicator of how many eggs you have available in reserve. This hormone is measured by a simple blood test and can be done at any time during your menstrual cycle.
AMH levels tend to decrease as women age but it is not unheard of for women in their twenties to have lower AMH levels. Depending on your AMH level it may not be in your best interest to proceed with egg donation or you may require high doses of medication for a successful outcome.
You should be aware that your AMH levels are used as an indication of success for Assisted Reproduction. If your AMH levels come back lower than expected, this doesn’t mean that you are infertile or that you will have difficulty conceiving naturally.
Antral Follicle Count (AFC) Test
When an ovarian follicle develops to a certain stage an antrum (fluid-filled cavity) develops within it. At this stage of development, it is called an Antral Follicle. Using a vaginal ultrasound scan, these partially developed follicles can be counted (Antral Follicle Count) providing a good indicator of the number of mature follicles that may be stimulated during an egg donation cycle.
Follicle Stimulating Hormone (FSH) and Luteinising Hormone (LH) test
Follicle Stimulating Hormone (FHS) and Luteinising Hormone (LH) are measured in a combined blood test performed at days 2-6 of your menstrual cycle, usually during your period.
Follicle Stimulating Hormone (FHS), produced by the pituitary gland, stimulates the follicles in the ovaries to mature. The eggs mature and the ovaries release estrogen. If there is not enough estrogen in the blood the pituitary gland releases more FHS to further stimulate the ovaries. Therefore, elevated levels of FHS can indicate a lower ovarian reserve.
Luteinising Hormone (LH) is also produced by the pituitary gland and helps to stimulate ovulation. Your doctor may compare FHS to LH.
Each of these tests alone may not be a good indicator of how successful your egg retrieval will be. Together, they paint a picture of how the doctor can plan for your egg retrieval cycle and whether an egg retrieval cycle is likely to be successful. It is important to discuss the results with the fertility doctor.
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