Determining Ovarian Reserve

It Starts With the Egg Quality

A healthy egg (ovum) is the basis of conception. Without this essential component, a viable pregnancy is not possible. Egg health is related to a number of factors including: a woman’s age, genetics, exposure to environmental toxins, nutrition, drug and alcohol consumption, stress, blood and oxygen flow, and hormonal balance.

Because a woman is born with all of the eggs she will ever possess, lifestyle factors beginning as early as birth can have a direct impact on the health and quality of her eggs. Moreover, the home to the eggs- the ovaries, are also impacted by these lifestyle factors. Each month at ovulation, chance of conception is based upon both the health of the egg and the ovarian environment in which the egg developed. Ovarian reserve is another fundamental factor linked to fertility.

Ovarian reserve refers to a woman’s current supply of eggs within her ovaries and is closely associated with reproductive potential. In general, the greater the number of eggs remaining, the better the chance for conception. As a woman ages, her supply diminishes over time, reducing her fertility, until all of the eggs are depleted at menopause.

Determining Ovarian Reserve Through FSH and AMH

determining ovarian reserveDiminished ovarian reserve can be diagnosed through hormonal blood panels, looking specifically at levels of follicular stimulating hormone, FSH, and anti-mullerian hormone, AMH, FSH levels are measured on Day 3 of the menstrual cycle.

Levels of FSH are dependant upon a negative feedback system between the ovaries and the hypothalamus and pituitary glands.

FSH from the pituitary gland signals to the ovaries to recruit antral follicles. These antral follicles begin to develop, and one of these recruited follicles will eventually grow large enough to become the ovulated ovum, or egg. As the follicles grow, they send their own hormonal signal back to the hypothalamus which shuts down the FSH secretion from the pituitary.

Healthy, responsive ovaries need very low levels of the hormonal signal from the pituitary.

In other words, well responding ovaries are reflected in low levels of FSH. High levels of FSH indicate the ovaries are not responding, which reflects poorer egg quality and a diminished ovarian reserve.

As General Knowledge. Let’s start from the Beginning…

FSH levels – In general:

Under 6 is excellent • 6-9 is good • 9-10 fair • 10-13 diminished reserve • 13+ very hard to stimulate Typically, evaluating FSH and AMH levels, based upon age, gives fertility health practitioners a very good indication of ovarian reserve and egg quality.

These values also may determine the path of treatment most likely to yield the highest success rate for a particular patient. For instance, a very high FSH and a very low AMH may lead some RE’s to move immediately to donor egg. Unfortunately, some clinicians only factor in FSH and/or AMH levels when determining whether or not to even take on a particular patient.

High FSH and low AMH indicate:

• Poor ovarian response to ovarian stimulation (“poor responder”) • Poor quality eggs • Poor quality embryos • Embryos with disproportionately high rate of chromosomal abnormalities (aneuploidy) • Reduced number of euploid embryos (balanced set of chromosomes) • Low pregnancy rates • High miscarriage rates

The Good News…….

But what most women don’t know, is that there are things you can do to help support the health of the ovaries and eggs, but it must be done for at least 90 days to have an impact. During the cycle of an eggs journey towards ovulation there is a window of opportunity, a period of time when certain factors can affect the health of the eggs that are preparing for ovulation.

#1-  Improve your Blood Flow and Proper Oxygenation

Blood flow and proper oxygenation is key to healthy ovaries and healthy eggs.. Blood flow can become impaired from stress, lack of exercise, dehydration. To increase blood flow to the ovaries follow these suggestions:

  • #1a – Stay hydrated: Dehydration can cause your blood to become thick and decrease circulation in the body, as well as many other issues. Make sure to drink purified water that is NOT bottled in plastic.
  • #1b – Move! Brisk walks, jogging, swimming, hiking, yoga, the elliptical, spinning, pilates- find something you enjoy doing and do it regularly.  While some clinicians advise against overexertion while trying to conceive, it is generally recommended that patients engage in mild to moderate aerobic activity.  Not only does it move your blood, it reduces stress which also encourages blood flow to your reproductive organs.
  • #1c – Get Fertility Massage or Learn Self Massage Techniques Massage is great for increasing blood flow to the reproductive system. You can have a massage therapist perform abdomen massage or find a therapist who specializes in fertility or Maya abdominal massage. There are also self-massage techniques that you can learn that you can do on your own at home to encourage blood flow to your ovaries and uterus.
  • 1d – And of Course, Acupuncture and Moxibustion! At Reproductive Wellness we can help you improving your ovarian reserve with acupuncture and Moxa. If you would like to talk with our team of fertility specialist in San Diego, please call 858 381 2281. We offer free complimentary consultations.  You can also start doing moxibustion at home, to help you improve fertility.

Are you trying to get pregnant with no success? Our team of natural fertility experts can help you improve your FSM and AMH so you can get pregnant faster, without going to IVF or other assisted reproductive techniques.


#2. Improve your egg quality through Nutrition

During this window of opportunity, what you are eating can also impact the health of your ovaries and eggs either positively or negatively. It’s up to you. The types of nutrients your eggs depend on are found in a diet dense in nutrition. Check out the Nutrient Dense Fertility Diet for a complete guide about eating for fertility and egg health. Here are some quick food suggestions for supporting egg health:

Top foods for egg health

  • Halibut
  • Salmon
  • Pumpkin seeds
  • Sesame seeds
  • Turmeric
  • Ginger
  • Royal Jelly
  • Maca
  • Fertility Greens
  • Broccoli
  • Berries

Foods that may damage egg health

    • Cigarettes
    • Caffeine
    • Alcohol
    • Sugar
    • Non-organic meats and dairy
    • Soda
    • Low Fat Diet
    • Processed Foods
    • Trans Fats
    • GMO Foods

#3. Take Supplements to improve your eggs

Take a Multivitamin A major key to supporting egg health and preparing the uterine lining is to take a prenatal multivitamin. Making sure your body has all of the nutrients necessary is a lot easier when you are taking a multivitamin.

My favorite is the 100% whole food Baby and Me from Mega Food, synthetic multivitamins won’t have the same effect. It is also a great idea to begin taking a prenatal multivitamin in preparation for pregnancy since there are specific nutrients needed by the embryo/fetus before pregnancy can even be detected.

Go to this link to get a list to my favorite supplements to improve egg quality. I created a category to make it easier for you. You’ll need to click the link, register and use the “search” area. Once there, look for “Egg Quality” and my favorite ones will show.


#4. Fertility Superfoods  

Fertility superfoods are nutrient dense foods that help to nourish the body with vitamins, minerals, antioxidants. One of my favorite ways to take fertility superfoods is to put them infertility smoothies. 

Maca is an incredible fertility super food. It helps to balance the hormones, but does not contain any hormones itself. It is able to do this by nourishing and balancing the endocrine system. This is essential in preparing for pregnancy and IVF because healthy hormonal balance greatly contributes to healthier eggs.

Royal Jelly is a fertility superfood which may help to increase the egg quality and quantities. Royal Jelly is the food that only the queen bee eats. What makes a queen bee the queen is eating royal jelly exclusively. She was an ordinary bee and then she was chosen and fed royal jelly and became the queen bee who lays up to 2000 eggs a day. It should be taken for at least three months before natural conception or IVF procedures begin. Royal jelly is the Queen bee’s equivalent of hormonal stimulation. Take daily for best results. Caution: If you are allergic or think you are allergic to bee’s or bee products, do not take royal jelly.

FertiliGreens is a nutrient rich green powder. It contains antioxidants, minerals, and proteins that help to alkalize the body and nourish your eggs. Take two teaspoons of the powder daily.

#5. Reduce Stress

We live in a fast paced world, and being a woman today has many blessings, one of them being a professional life. But are we constantly trying to hurry up and rush things in order to meet all of our commitments? Dr. Allen Morgan and Dr. Douglas Rabin (reproductive medicine physicians) discovered that “stress also has a detrimental impact on fertility. Women who are constantly under stress produce prolactin, cortisol, and other hormones, which can interfere with or even block regular ovulation.”. The types of stress they are talking about range from traumatic, to less cataclysmic but still upsetting situations, such as an ongoing conflict at work. So, if you are trying to improve your egg health, reducing your stress levels should be a major focus in your life. Take a stress survey here to see if your fertility might be stressing you out. How can this be achieved? Well, first it needs to become a priority. Book some quiet time in your calendar for yourself. During your “quite time” you could:

  • Go for a walk
  • Take a bubble bath (my favorite)
  • Cuddle up with a good book
  • Get a professional massage or reflexology treatment
  • Drink some relaxing herbal tea, such as chamomile, kava kava, or peppermint
  • Practice meditation
  • Go to therapy
  • See an NLP coach

You could also create a ‘stress support system’ for yourself so you have a go to plan when things get stressful, and have habits already in practice so stress does not affect you as much when it does happen. This could be one or two things you do each day that become a habit.

My current ‘stress support system’ is daily meditation, weekly acupuncture, deep breathing and EFT as needed. There are many options to choose from, make yourself a priority and create a plan for yourself you can put into practice right away. “In a study of women who were not ovulating, one group received cognitive behavior therapy and the other group was just observed. 80% of the women who received cognitive behavior therapy started to ovulate again, as apposed to only 25% from the randomized observation group.” We hope this information has been useful. Keep reading about Egg quality, FSM and AMH  in this blogpost.

If you would like to know more, here is what you could do:

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