Ovarian Reserve Screening Test

When you’re born, your ovaries already contain all the eggs you will ever have. With age, both egg quantity (A.K.A. ovarian reserve) and egg quality decrease. While everyone’s eggs may deplete at different rates, every female will, eventually, run out and this culminates in menopause.

One of the signs of decreasing ovarian reserve is higher levels of follicle-stimulating hormone (FSH) at the start of the cycle (because as we age, less hormones are produced in the ovaries). This leads to increased FSH production from our pituitary gland, hence the higher FSH.).

It’s important not to confuse egg quantity with egg quality, which unfortunately also declines with age. Egg quality is critical for a successful pregnancy. And biologically, it only takes one good quality egg—along with good quality sperm and a receptive endometrium—to make a baby.

So if you’re trying to conceive at home/without medication, and you know that you’re ovulating, low egg quantity won’t impact your fertility (since you usually ovulate one egg at a time anyways in natural cycles).

But knowing you might have diminished ovarian reserve can be useful for planning if, say, you’re trying to have a baby. Doctors recommend seeking a fertility consult if you’re under 35 years old and have been unsuccessful after 1 year of trying, or if you’re over 35 and have gone 6 months without success. If you possibly have diminished ovarian reserve, it would be recommended to expedite these timelines, and get diagnostic testing for a full ovarian reserve workup.

If you’re not currently trying, but considering having a baby in the future, it’s best to speak to your doctor about your fertility options. If you might have a diminished ovarian reserve, it would be recommended to not delay these important conversations.

Anyone who’s curious about their ovarian reserve can benefit from this test’s results, including those struggling to conceive, or those not yet trying but who may want children someday. The goal is to give you an at-home tool to help understand your FSH levels. It’s an opportunity to flag rising FSH, which suggests a decreasing ovarian reserve, and seek further diagnostic testing or care from your doctor early, if needed.

If you’re looking for an inexpensive and easy at-home test to screen for low ovarian reserve, this is a great place to start.

To take the test you’ll need a receptacle to catch urine (customers love our reusable and collapsible Collection Cup) and a timer, along with the Ovarian Reserve Screening Test itself. You’ll need to test on day 3, 4, and 5 of your cycle (with day 1 being the first full day of bleeding) for 2 cycles, so having a general idea of when your period will start is helpful too. (And of course, you’ll need to be off hormonal birth control, which alters your natural hormone levels, for one cycle.)

Hormones fluctuate based on a number of factors, so it’s best to take the test a few times. We recommended taking the test on days 3, 4, and 5 of your cycle, and then repeating the steps the following cycle. If you get wildly different results, despite using the test as instructed, it’s time to visit a doctor for more investigation.

Results between 10 and 25 mIU/mL suggest an elevated FSH level and a risk of diminished ovarian reserve. Remember, low ovarian reserve doesn’t mean that you can’t conceive. This test is an advanced screening opportunity to identify high FSH levels early, and prompt you to seek a fertility consult earlier,which might include further diagnostic testing to assess your ovarian reserve through bloodwork and a pelvic ultrasound.

Levels higher than 25 mIU/mL indicate that you may be transitioning into menopause (or have already, especially for results above 50 mIU/mL). Consult a doctor for next steps and immediate support.

Results that are 10 mIU/mL or lower are considered normal FSH levels in terms of ovarian reserve, though a normal result doesn’t rule out a diminished ovarian reserve–only a full diagnostic workup at a clinic would provide more specific details.

Just like a high FSH doesn’t mean that you can’t conceive, a normal FSH doesn’t guarantee you will conceive easily. There are many factors that can impact one’s ability to get pregnant. Again, ovarian reserve is a measure of egg quantity not quality, and FSH is not an indicator of egg quality.

Regardless of FSH screening results, if you aren’t having regular cycles or have other reproductive health red flags, we recommend connecting with your doctor to get more insights into the underlying cause.

Knowing that hormones fluctuate, for the best accuracy with this at-home test, our team of doctors recommend testing 3 times (days 3, 4, and 5) over 2 cycles. If either cycle shows 2 tests with elevated or high FSH, we suggest seeing a doctor to get more information. Need help finding a clinic? We can help connect you through this form.

Yes, that’s how you’ll get your most accurate results, because the hormone levels are more concentrated at this time.

We recommend using the test in the morning on cycle days 3, 4 and 5. Count from day 1, which is the first day of full bleeding (heavy flow) from your period. If you start your full bleed after 5 p.m., you can consider the next day your day 1. If you are past cycle day 5, then you will need to wait until the next cycle. And if you don’t have regular cycles, go see your doctor for a workup.

It’s generally defined as a decreased number of oocytes—so, a lower egg quantity. Fertility doctors routinely measure ovarian reserve, since it helps them with counselling and determining treatment options and their success rates. A diminished ovarian reserve may be associated with an earlier onset of menopause, depending on your age. It may also suggest a lowered response to fertility medications (ovarian stimulation):: you might retrieve fewer eggs per cycle, so it can be a valuable piece of info to manage expectations on success rates. Having a lower success rate per treatment cycle may result in needing to undergo several cycles so it’s important for budgeting and planning, as well . DOR is a clinical diagnosis (made by your doctor), and it’s important to note that elevated FSH is only one of the markers. This screening test can highlight the need for further diagnostic testing, which may include bloodwork and an ultrasound. Elevated FSH is not a measure of egg quality, and doesn’t predict whether or not you will conceive without intervention (remember, in unmedicated cycles, we only expect one egg to be released at a time, so quality is the critical piece for success if you’re trying at home).

Menopause happens when the ovaries stop releasing estrogen and progesterone and no longer ovulate. The clinical definition is when someone has not had a period for 12 consecutive months. The transition period leading up to menopause is called perimenopause, which can last several years. In this transition period, many experience irregular cycles and a variety of symptoms associated with hormonal fluctuations.

If after continuous testing for 3 days, 2 or more of your FSH results are 25 mIU/mL or more, it means that you may be transitioning into menopause. If your results are higher than 50 mIU/mL, it shows that menopause has either already occurred or is imminent. Consult a doctor for next steps and for immediate support.

Our Ovarian Reserve Screening Test detects FSH levels in your urine to help screen for diminished ovarian reserve. Your results may guide you to check in with a doctor earlier and explore further testing. The goal is to equip you with more info sooner (and at home) about your egg quantity, to help you plan for your reproductive future. At the end of the day (or, you know, cycle), fertility is complex and this test alone doesn’t determine if you are fertile, can become pregnant, or your overall egg quality. It’s an at-home fertility screening test that gives you insight into your timeline—not diagnostic— and FSH is not the only indicator of ovarian reserve.