The decision to start a family is an exciting time for any couple. It can also be a daunting and confusing time, as there are likely many questions about fertility and ovulation that remain a mystery to you - like how many eggs does a woman have?
Understanding how many eggs you have and the process eggs go through can help give you a better idea of how your body works so you can make informed decisions regarding your health and when the best time is to start a family.
In this article, we’ll help you understand more about female egg count and how you can get tested to determine how many you have left.
Women are born with all the eggs they'll ever need. As a fetus, the ovaries typically hold between 6 to 7 million eggs. No new eggs are produced after this stage, but the number significantly decreases over time.
At birth, there are approximately 1 million eggs. However, by the time a woman reaches puberty, only 300,000 eggs remain. From here, only 300 to 400 will be ovulated during a woman’s reproductive lifetime.
The reason fertility can drop as a woman ages is due to the decreasing number of eggs, as well as the quality of the remaining eggs.
Two different things are happening as you get older; there is a decrease in the number of eggs in your body and a decrease in the quality of eggs in your body. When you put these two factors together, that’s why it’s more difficult to get pregnant as you age.
A simple analogy to demonstrate this is to imagine the inside of your ovaries as a bank vault. Inside the vault are the one million eggs that you are born with. At birth, those million eggs fill up the vault. Over the course of your life, eggs come out of the vault until the vault is empty once you reach menopause.
Every month you lose a group of eggs. From those eggs, one will be chosen to ovulate and the rest will die. Additionally, the amount of eggs that come out each month are proportional to the amount of eggs you have left.
This proportion of eggs is key to testing a woman’s ovarian reserve.
Ovarian reserve is the supply of eggs a woman has for the future. Or, to stick with the vault analogy, it’s how many eggs are left inside the vault. Doctors can determine the ovarian reserve by testing the eggs outside of the vault.
When you’re young (less than 30), you have a lot of eggs. For simplicity, let’s say 20 eggs are released each month. Eggs grow inside a fluid filled structure called a follicle (fertility doctors use egg and follicle interchangeably). Each time a group of eggs is released from the vault, the brain releases follicle stimulating hormone (FSH) to stimulate one follicle (egg) to grow.
As that follicle grows, the egg matures, makes estrogen, ovulates, and, if the egg isn’t fertilized, another group of eggs is released the following month.
The amount of eggs (or follicles) released each month is proportional to your age. That’s why the chances of getting pregnant decreases as you age. Fertility doctors will use the number of eggs released each month to determine how many eggs you have left. For example, if you are releasing 20 eggs a month in your 20s, by the time you are nearing menopause, that number is likely closer to two eggs.
In short, the fewer eggs outside, the fewer eggs inside.
There are several ways to measure ovarian reserves. Two of the most common are an antral follicle count test and an anti-mullerian hormone (AMH) blood test. Below is a brief description of both.
This test uses high quality ultrasound equipment to evaluate a woman’s ovarian reserve. Because your eggs are sealed inside a vault, fertility doctors use ultrasound equipment to count the number of eggs released as a surrogate marker for how many eggs are inside.
In short, the fewer eggs outside means the fewer eggs inside, and vice versa.
It’s also important to note that this test will provide the quantity of eggs a woman has left, but not the egg quality.
AMH is a substance produced by granulosa cells in the ovarian follicles. Because AMH is only produced in small ovarian follicles, blood levels of this substance can be used to determine the remaining egg supply.
According to the Advanced Fertility Center of Chicago, the guidelines for interpreting your AMH blood test results are:
Higher levels of AMH correlate with more eggs and a higher ovarian reserve. Lower levels of AMH correlate with fewer eggs and a lower ovarian reserve. It’s also important to note that because labs use different equipment, results might vary slightly depending on the lab.
Additionally, AMH levels naturally decline with age, so it’s normal to see lower ovarian reserves in your 30s, 40s, and 50s. The Cleveland Clinic provides estimates as they correspond to different age groups:
You can receive an AMH blood test in several ways, including:
It’s important to mention that an AMH blood test can be performed at any point during your menstrual cycle. This is because AMH does not fluctuate throughout the month.
Understandably, fertility testing can be stressful. To minimize stress, taking an AMH blood test in the comfort and privacy of your home might be preferential - and Getlabs can help.
Getlabs provides a safe, private, and convenient solution to receive an at-home AMH blood test. By sending mobile phlebotomists directly to you, you can track your fertility without leaving the house. With over 5,000 lab tests available, you can also book a nearby phlebotomist for many of the tests your doctor may recommend.
Getlabs sends a nearby medical specialist to you to collect your labs for Labcorp and Quest. Available same-day, nationwide.