"When you look at an ovary by ultrasound, you see tiny follicles that could harbor an immature egg. If you do a count of the number of follicles, you have a first estimate of the fertility potential —even before a single blood test comes back," explains Dr. Avner Hershlag, chief of Northwell Health Fertility.
I had six follicles on one ovary and eight on the other, slightly lower than average for a 29-year-old woman. It had crossed my mind that my results might be less than ideal. I have polycystic ovarian syndrome (PCOS), and fertility can sometimes be an issue when you have this condition.
I had also been on birth control for just shy of 10 years in order to manage the other unpleasant PCOS symptoms (like irregular, two-week periods that basically put me out of commission). At a follow-up appointment a few weeks later, I learned being on birth control for this long had apparently lulled my ovaries to sleep, so to speak. In addition to having less follicles, my level of AMH (anti-mullerian hormone)—which gives a snapshot of your ovarian reserve—was low. "The AMH standard across different practices across the world is to be about 1.1," says Dr. Hershlag. Mine was around .9.
This didn't mean I wasn't a candidate for egg freezing —it just meant I'd have to pump myself up with more drugs to get these eggs to mature. The rest of the appointment taught me so much. I learned that the further a woman gets into her 30s, not only do her number of eggs decrease, but the number of "normal" eggs also start to dip. I learned that no matter what number of eggs you freeze, there's no amount that guarantees a 100 percent chance they'll become a healthy embryo—but that there are certain numbers that will put you in a more successful bracket (around 20 for my age and test results). "When I counsel a patient, I discuss the specific number of eggs that the patient should have frozen in order to have a good potential to have a baby, which is dependent on the patient's age and fertility potential," Dr. Hershlag explains. After it was over, I had an entire folder's worth of information to help prepare me for what was to come.