Ovarian reserve function: This refers to the number and quality of follicles retained in the ovaries, reflecting the reproductive endocrine function and fertility potential of women. With regular menstruation, you will notice that the leukorrhea becomes clear and translucent, like egg whites, in a stretched shape about 14-15 days from the first day of menstruation each month, which is a sign of ovulation. If your menstruation is regular, with normal volume, color and shape, and the leucorrhea shows this cyclical change, it means that your ovaries are functioning well. Declining ovarian reserve function, on the other hand, is manifested by delayed menstruation, low volume, infertility, and even premature ovarian failure and early menopause symptoms. Common assessment of ovarian reserve function 1. Age A woman expels about 400 egg cells during her lifetime. The number and quality of follicles decreases with age, and the rate of fertility decline accelerates significantly after the age of 35 and plummets after the age of 40. However, actual age is not equal to ovarian age, let alone ovarian reserve function. Women of childbearing age may also experience premature ovarian failure, resulting in poorer fertility. On the contrary, there are cases of older women with very young ovaries whose ovarian reserve function is still good. 2. Basal sex hormones Women’s sex hormones change cyclically, and we usually choose to test them on the 2nd-5th day of menstruation (no fasting required). For those who have scanty menstruation or have been amenorrheic for 3-6 months, and whose ultrasound indicates follicles less than 1cm, the test can be done directly. The six sex hormones are follicle stimulating hormone (FSH), luteinizing hormone (LH), estrogen (E2), progesterone (P), androgen (T), and prolactin (PRL). FSH, LH, and E2 are all relatively sensitive indicators to evaluate ovarian reserve function. As ovarian function declines, both FSH and LH rise, with FSH rising more dramatically than LH, so the first to appear is an increase in the FSH/LH ratio, which appears earlier than an increase in FSH. If FSH>10U/L, or FSH/LH>3, it indicates a decrease in ovarian reserve function. AMH is produced by ovarian granulosa cells and is barely detectable in the body during the neonatal period, but gradually increases as the body matures, reaching its highest level after sexual maturation and disappearing after menopause, The AMH can reflect the beginning of the decline of ovarian function when FSH, E2 and ultrasound have not yet changed, and can be detected at any time of the menstrual cycle. INHB is mainly produced by the developing small sinusoidal follicles and can be used as an indicator of the developing follicle function and the reserve function of the ovary. In women with declining ovarian reserve function, serum INHB decreases on day 3 of the menstrual cycle, while the peak of FSH does not appear, so INHB is better than and earlier than FSH in reflecting ovarian reserve function. 5. Ultrasound Under ultrasound during menstruation, you can see many small follicles in the ovaries, these small follicles are the tiny houses where the eggs live, which are medically known as “sinus follicles”. The number of sinus follicles can be a good indicator of the amount of “stock”. The number of sinus follicles in a normal person is 5-6 per section, and its number decreases with age, if the number of sinus follicles is <4, it indicates a decrease in ovarian reserve function.