Measuring Ovarian Reserve

Generally speaking, the age of menopause is the day you run out of eggs. So the obvious question is, when will that be, or to phrase it a different way,: Women want to know are they loosing eggs. Older women, younger women, many of us have the same question. Women seeking fertility and women seeking not to be fertile, and women wanting to establish if these hot flashes are menopause or something else all want to know: just how many eggs do they have left. Their Gynos want to know as well, and how we can determine this is that has been as critical as knowing that running out of eggs may have really occurred. We tend to have clues, the age of average menopause, the age your mom went through menopause, and other factors. Ultrasounds have been used to look at how many growing eggs are in the ovary at the start of the menstrual cycle to determine if you have many eggs or fewer than you should,  measurements of your estrogen levels have been used to just name a few tests, and just the plain old obvious: are you still having regular periods. Now new blood tests may be what you need to determine if you have any ovarian reserve, or to put it bluntly, do you have any eggs left. So you may need a series of measurements. One set is really not enough, and beginning these tests in your 30s may help them be more useful.. One random blood test is just not enough to say where you are in the menopausal process. Just like you can’t say if a kid has grown just because they seem tall in their class, you have to know what the height was at the beginning and the end of that school year. Two tests that we now use are FSH, and AMH (some doctors also use inhibin B). If you know your basal (at the point you are starting to look)  FSH and anti-mullerian hormone (AMH) levels and  then your later levels, you may have a clue.For women without a uterus they often do have to rely on symptoms and blood tests, because obviously they don't have periods any more. For instance before and after measurements when you are having a hysterectomy you can determine if your hysterectomy caused diminished ovarian reserve when you specifically chose to keep your ovaries, at least this is what Hehencamp and researchers did when they were trying to determine if uterine artery embolization (UAE) caused ovarian damage. Now ovarian damage or diminished reserve doesn’t always mean menopause. But for smokers, and women with various inflammatory diseases like lupus, an early age of menopause might be predicted. In the case of UAE about 20% of premenopausal women over the age of 45 were found to pop into menopause anyway in earlier work by a Dr Tulandi. It is only about a 1/100 chance of becoming menopausal if you are younger and have UAE A bit technical, but your gyno will know when you ask about these tests, call to see if you need them!

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