Ovarian reserve

Ovarian reserve is the number of eggs present in a woman’s ovaries. Statistically, women over 35 begin to have a noticeable reduction in ovarian reserve and egg quality, so their pregnancy probabilities decrease significantly.

Although it is impossible to restore ovarian reserve, it is possible to carry out an ovulation induction treatment, followed by an in vitro fertilization cycle, which allows the extraction of multiple eggs hoping to obtain some good quality ones.

If the patient does not have any viable eggs, she may resort to egg donation, which offers up to 80 percent success rates, regardless of the woman’s age

What is ovarian reserve?

Ovarian reserve refers to the number of eggs present in a woman’s ovaries, and is directly linked to her reproductive potential. A good ovarian reserve should be of at least six eggs.

Unlike men, who produce sperm throughout their lives, women are born with about 1 million eggs in her ovaries and do not generate new eggs. This reserve decreases with each passing month, and after 35, this reduction is even faster.

80 percent of women exhaust their ovarian reserve between age 45 and 50, leading to menopause (menstruation interruption caused by egg depletion). However, about 15 years earlier, a noticeable reduction in the number and quality of a woman’s eggs in her ovaries. Age is therefore a very important factor that critically affects a woman’s fertility.

Reduced ovarian reserve main symptoms

While a decline in ovarian reserve is usually asymptomatic, some hints include shorter menstrual cycles, absence of cervical mucus and infertility.

Moreover, when ovarian reserve reduction is linked to Premature Ovarian Failure (POF) its symptoms are very similar to those of menopause:

  • Irregular menstrual periods
  • Amenorrhea (or menstrual period absence)
  • Hot flashes
  • Night sweats
  • Insomnia
  • Vaginal dryness
  • Decreased libido
  • Painful intercourse
  • Energy loss
  • Irritability and frequent mood swings
  • Concentration difficulty
  • Thyroid related issues

Ovarian reserve reduction causes

From age 35 ovarian reserve of women starts to decline. Once they reach 40, however, poor quality eggs usually outnumber the healthy ones, so the patient’s chance of getting pregnant is reduced significantly and the odds of having a baby with a genetic disorder increases.

Age is the most influential factor on a woman’s ovarian reserve, however, some young women may also have a low ovarian reserve caused by:

  • Genetic abnormalities
  • Immunological problems
  • Cancer treatments such as chemotherapy or radiotherapy
  • Smoking
  • Exposure to toxic agents

How is ovarian reserve measured?

In addition to a patient’s physical examination and medical record analysis, a FSH (follicle stimulating hormone) and estradiol blood analysis is performed on the third day of the patient’s menstrual cycle to measure these hormones blood levels. High levels in this stage of a woman’s menstrual period may be indicative of a low ovarian reserve.

It is also advisable to perform a transvaginal ultrasound (or pelvic vaginal ultrasound), during which the doctor inserts an ultrasound probe into the patient’s vagina to examine her ovaries.

Transvaginal ultrasound is simple, painless and can determine the number of eggs present in a woman’s ovaries.

A normal count would range between 15 to 20 follicles, while a count of less than six follicles indicates insufficient ovarian reserve.

Treatments to achieve pregnancy when you have a low ovarian reserve

Although it is impossible to restore ovarian reserve, it is possible to carry out an ovulation induction treatment, followed by an In-Vitro Fertilization cycle, which allows the extraction of multiple eggs hoping to obtain some good quality ones.

If the patient does not have any viable eggs, she may resort to egg donation, which offers up to 80 percent success rates, regardless of the woman’s age.

If the woman does not have viable eggs may resort to egg donation, offering success rates of up to 80 percent for women who want to be mothers regardless of age.

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