A practical approach to recent advances in ovarian reserve testing

It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity Charles Dickens, A Tale of Two Cities Ovarian reserve conceptually may be defined as a woman's supply of oocytes capable of producing a healthy baby, though definitions vary with respect to emphasis on oocyte quantity, quality, or fertility. Practically, ovarian reserve is difficult to measure and quantify and little consensus exists as to why and how to measure it. While the clinical utility of ovarian reserve tests (ORTs) is currently advancing dramatically in the ability to improve medical care, paradoxically, so is the potential for use of ORTs to misguide clinical care. Therefore, the goal of this review chapter is twofold. First, tell the Tale of Two Cities-the best of progress in ORT use to benefit patients and the worst of obstacles which reduce this benefit. Second, to provide a methodical approach to ORT use, ready for immediate application, to maximize the benefits, and avoid the pitfalls