What is ovarian reserve and how is the testing for ovarian reserve done?

Ovarian reserve is the best method to evaluate the reproductive potential of the woman's ovaries. The testing requires measurement of menstrual day 2-4 follicle-stimulating hormone (FSH) levels, B3 inhibin and the clomiphene citrate challenge test (CCCT). Clomiphine citrate is Clomid/Serophene. For the CCCT, hormone measurements for FSH and estradiol are made on menstrual day 2-4, Clomid/Serophene is administered, 2 tablets on days 5-9, and FSH levels are measured on menstrual day 10. Elevated FSH levels, on either menstrual day 2-4 or 10, are indicative of diminished ovarian reserve. Abnormal levels of FSH must be determined for each laboratory, so caution should be taken when interpreting the results. An “antral” count on day 2-4 can be performed with an ultrasound for additional information on the number of “immature” follicles available for stimulation.