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What’s Up With Female Egg Counts: The Basics

June 21, 2018
Katie Visco

The female body is amazing. By the time a baby girl is born, she already has all of the eggs that she will have throughout her lifetime. Unlike male sperm production, her body never produces more. The older a woman gets the faster her eggs start to die, which is when egg counts start to have an impact on fertility. In today’s article we are going to dive into a few topics:

  • The basics of female egg counts
  • How egg counts affect fertility
  • How to get your eggs tested

The Basics of Egg Counts

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‍Women are born with between 1-2 million eggs

At just 20 weeks gestation, a baby girl has the most eggs she will ever have, about 7 million. Yes, that’s right: 7 million. Keep in mind, these are immature eggs, all contained in tiny follicles that mature every cycle during a woman’s fertile years (mature follicles are called antral follicles- you’ll learn more about how they can help determine egg count later). This number decreases throughout her life. At birth her egg count has dropped to between 1-2 million, and when she has her first menstrual cycle there are only about 300,000 left. It’s estimated that a woman will only ovulate about 450 eggs in her lifetime, less than 1% of her initial count. When a woman gets older, it’s not the fact that she loses eggs that changes: it’s the speed at which she loses them. At age 30, the rate that her eggs are dying starts to speed up, and at 35 her egg counts plummet. By age 40, a woman only has a 5% chance of becoming pregnant every month, and part of this is due to the decrease in egg quantity.

How Egg Counts Affect Fertility

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‍ Egg counts have a big impact on fertility

Egg counts really start to impact fertility when a woman is about 35. As she ages, her “ovarian reserve”, or the amount of egg-containing follicles in the ovaries, starts to diminish. As the ovarian reserve starts to decline, the follicles become less and less responsive to stimulants such as FSH (follicle stimulating hormone). This ties into egg quality, which is another factor in infertility. The older a woman gets, the older her eggs get, and there is a much larger chance of a genetic abnormality called aneuploidy (too many or too few chromosomesin the egg). Egg quantity isn’t the only thing that affects fertility, but it does go hand-in-hand with egg quality, and both of these factors play a very big role in the chances of getting pregnant, especially as a woman gets older.

How to Get Your Egg Count Tested

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‍Getting your eggs tested can help figure out your fertility

If you’re struggling to conceive and think that you have a low egg count (or if you just want some information about your body), there are ways to test your egg count. These tests aren’t going to tell you exactly how many eggs you have left, or even predict your possibility of getting pregnant, but they will give you an idea as to what your ovarian reserve is.

Blood tests for hormones

Blood tests will check the levels of two different hormones, which will in turn give you an idea as to what your ovarian reserve is: FSH (follicle stimulating hormone) and anti-mullerian hormone (AMH).

FSH Test

According to My Future Baby, “FSH is a hormone made by the pituitary gland that stimulates the egg follicles (sacs containing the eggs) to grow every month. The egg follicles in turn make estradiol which turns off the FSH production so that only one egg is recruited and ovulated per month.” In other words, FSH is the hormone that turns immature follicles into antral follicles (remember, antral follicles are mature ones). If you have low ovarian reserve, the level of FSH will be fairly high because the follicles will need more of this hormone in order to fully mature. A number less than 10 is a good sign, and anything over 12 indicates a low egg count. Blood tests to check FSH levels are normally performed when you’re on day three of your period because estrogen (a hormone that cancels out FHS) levels are lowest on that day, resulting in a more accurate FSH count.

AMH Test

Anti-mullerian is a hormone released by cells that are involved in the maturing of antral follicles. The amount of AMH correlates with the amount of antral follicles- unlike with FSH, the higher the AMH count, the higher the antral follicle count. Blood tests to measure AMH can happen at any time during the month. Any value less than one suggests a low ovarian reserve.

Antral follicle count ultrasound test

An ultrasound won’t be able to count every egg that is in your ovaries, but through the antral follicle count (AFC) test you’ll be able to see how many antral follicles you have. The optimal AFC is between 15-20 over the two ovaries. An AFC less than 10 indicates a low egg count. Although this test can accurately estimate your antral follicles, especially with the rapid improvement of ultrasound technology,  it’s still possible for the technician to make an error, so it’s a good idea to supplement the ultrasound with a blood test.

The female reproductive system is complex, and egg counts are no exception. Just to review, here’s a rundown of the basics: A woman is born with the eggs that she will have throughout her lifetime, about 1-2 million. Even though that number is very high, she will only ovulate about 450 of those eggs which means that an estimated 99% of them will die. How does this affect fertility? Well, although factors such as quality of the eggs come into play, the lower the egg count, the lower the chance of getting pregnant. This is partly due to the fact that after 35, the rate at which eggs die starts to speed up. If you are curious about getting your eggs tested to get an estimate of how many you have left, look into blood and ultrasound testing options.

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