Let a child be!

The EmbryLife Center offers a whole range of services for diagnostics and treatment of both female and male infertility. Our specialists use American IVF technology: we work according to guidelines that have shown proven results in thousands of US patients. This technology has implicit excellent laboratory equipment capabilities, in strict compliance with ASRM (American Society for Reproductive Medicine) and ESHRE (European Society of Human Reproduction and Embryology) requirements.

EmbryLife is the only clinic in Russia that has been accredited by the American Association of Embryologists.

(812) 327-50-50

35 Sadovaya St., St. Petersburg, Russia

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What is ovarian reserve?


What is ovarian reserve?

The ovarian reserve assessment is necessary for selecting a method for infertility treatment and a pattern of ovarian stimulation. The ovarian reserve means the functional reserve of the ovaries, which reflects the number of follicles located therein (primordial pool and growing follicles).

newborn baby

The ovarian reserve indicators are used for predicting the ovarian response to ovulation stimulation by gonadotropins. Low ovarian reserve indicators may be the reason for inadequate or poor response to stimulation. When assessing the ovarian reserve, the doctor takes into account the age of the patient, AMH (Anti-Müllerian Hormone) level determination, FSH (follicle-stimulating hormone) level on the 2nd-3rd day of the menstrual cycle, antral follicle count in the ovaries during U/S (2 to 10 mm in diameter), both in combination and separately.

What is AMH?

AMH is a precise marker of the ovarian reserve. The hormone is produced by preantral and small antral ovarian follicles with dimensions of up to 8 mm, thus, it may reflect the follicle pool size, i.e., the reproductive potential of a woman. The AMH level varies insignificantly from one cycle to another and also within one menstrual cycle of a woman, and it does not depend on the FSH level.

What causes a low AMH?

Besides age-related AMH decrease, it should be noted that the use of drugs inhibiting the ovarian function (GNRH agonists, combined oral contraceptives) may also significantly decrease AMH levels. Due to the simplicity of studying and interpreting results, this indicator is widely used in current practice. However, it should be noted that the indicators may vary significantly from one laboratory to another.

What are antral follicles?

Antral follicles are small follicles (2 to 8 mm in diameter) that can be observed, measured and counted through ultrasound study. The antral follicle count is directly related to the number of ovarian primordial follicles that are only observable under a microscope. Each primordial follicle is an ovum precursor. That is, the antral follicle count (AFC) as measured by U/S on the 2nd-3rd day of the menstrual cycle precisely reflects the current ovarian reserve conditions. Note that the AFC may vary from one cycle to another and depends to a significant degree on the assessment by the specialist conducting the testing

Poor ovarian reserve.

The ovarian reserve assessment makes it possible to define a risk group for low follicle count. Figure: age-related AMH decrease.

The presence of 3 or less oocytes during standard stimulation represents a poor response. According to September 2015 reports of the American Society for Reproductive Medicine, the delivery rate per an IVF cycle in women with poor response to stimulation was 4% (5 to 7% according to European reports). And the pregnancy and delivery rates do not depend on the patient’s age. But if 4 or more oocytes have been obtained following stimulation, the delivery rate per the IVF cycle grew 2 and more times.

Therefore, the main task of EmbryLife physicians is obtaining as many oocytes as possible in such patients.

The presence of 3 or less oocytes during standard stimulation represents a poor response. According to September 2015 reports of the American Society for Reproductive Medicine, the delivery rate per an IVF cycle in women with poor response to stimulation was 4% (5 to 7% according to European reports). And the pregnancy and delivery rates do not depend on the patient’s age. But if 4 or more oocytes have been obtained following stimulation, the delivery rate per the IVF cycle grew 2 and more times.  Therefore, the main task of EmbryLife physicianThe presence of 3 or less oocytes during standard stimulation represents a poor response. According to September 2015 reports of the American Society for Reproductive Medicine, the delivery rate per an IVF cycle in women with poor response to stimulation was 4% (5 to 7% according to European reports). And the pregnancy and delivery rates do not depend on the patient’s age. But if 4 or more oocytes have been obtained following stimulation, the delivery rate per the IVF cycle grew 2 and more times.  Therefore, the main task of EmbryLife physicians is obtaining as many oocytes as possible in such patients.s is obtaining as many oocytes as possible in such patients.

How to enhance the response to stimulation?

Currently, the EmbryLife Clinic uses a vast number of methods for enhancing the response to stimulation. Some protocol options used for enhancing the ovarian response to stimulation:

  • Protocol using GNRH antagonists
  • Using GNRH micro-doses in the protocol
  • Long-term protocol
  • Luteinizing hormone addition during stimulation
  • Letrozole + FSH + GNRH antagonists
  • Use of dehydroepiandrosterone
  • Use of growth hormone

 The IVF protocol for a low ovarian reserve is the joint creative work by an EmbryLife physician and a patient, based on fundamental knowledge, experience and up-to-date technologies.

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