Diminished Ovarian Reserve

Diminished Ovarian Reserve: Understanding Low Egg Reserve and Your Fertility Options

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What is Diminished Ovarian Reserve?

Diminished ovarian reserve (DOR) is a condition where the ovaries contain fewer eggs or low quality eggs than expected for a woman’s age. It is sometimes referred to as low ovarian reserve or low egg count. Since a woman’s eggs are important for conception, having fewer eggs can make conception more difficult. The ovarian reserve will decline naturally with age. But some women experience this decline much earlier than expected, which may lead to fertility issues.

Understanding Ovarian Reserve

Ovarian reserve is referred to as the quality and quantity of eggs that are remaining in a woman’s ovaries. Every woman is born with a large number of eggs they’ll ever produce. When a female fetus is in the mother’s womb, she already has a finite number of eggs.  By birth this will decrease to an extent. The rate of egg loss increases by the age of 35. Actual egg loss differs from person to person, but these are the average number of eggs a woman possesses throughout her life:

20 Weeks Gestation: 6 to 8 million eggs

At birth: Around 1 to 2 million eggs

Puberty: 300,000 to 400,000 eggs

Age 40: 25,000 eggs

Menopause: Less than 1000 eggs

Even though you only need one egg to get pregnant, your odds of conceiving may become less when your ovarian reserve decreases.

How Does Diminished Ovarian Reserve Affect Fertility?

Diminished ovarian reserve refers to a situation where a woman’s ovary contains a decreased number of eggs or a decline in egg quality occurs. When a woman experiences diminished ovarian reserve it indicates that the overall number of eggs available for ovulation is lower than that of women in her age group. This condition does not imply that achieving pregnancy is unattainable but it does diminish the likelihood of conception. As a result of this circumstance some women may require fertility treatments to enhance their prospects of conceiving.

Symptoms of Diminished Ovarian Reserve

Women with DOR may not have high symptoms until they try to get pregnant. Most of them will be unaware about the condition. However, some common symptoms of diminished ovarian reserve include:

1. Shorter Menstrual Cycles (Less than 25 Days Between Periods)

The period of a normal menstrual cycle is 28 to 35 days. But in certain cases, where the woman is suffering from DOR, may experience a 25 day cycle, which is shorter than usual. This will shorten the overall cycle. The ovaries respond differently to hormonal signals, which causes early ovulation and faster decline in hormone levels, thus shortening the overall cycle.

2. Irregular or Missed Periods

Difficulty in predicting ovulation due to cycles caused by DOR can lead to missed periods or unpredictable menstrual cycles.

3. Lighter or Heavier Menstrual Bleeding Than Usual

Alterations in menstrual flow is also an impact of this. Due to decreased estrogen level, some women may have lighter periods. While others, due to disrupted hormonal balance affecting the uterine lining may experience heavier bleeding.

4. Struggling to conceive despite attempting for months

One significant sign of ovarian reserve (DOR) is difficulty in getting pregnant, due to a decrease in the number of eggs for fertilization and implantation, processes becoming more precarious as a result. If a woman has been attempting to conceive for over a year without success, should contemplate undergoing fertility testing that includes an assessment of ovarian reserve.

5. High FSH (Follicle-Stimulating Hormone) and Low AMH (Anti-Müllerian Hormone) Levels

FSH or Follicle Stimulating Hormone is responsible for prompting the ovaries to create eggs in the body, as needed for reproduction purposes. When the ovarian reserve decreases in level or quality over time the body responds by producing FSH to make up for the deficit. A heightened FSH level—usually exceeding 10 to 15 mIU/mL—indicates a decline in function and potential reproductive challenges ahead.

AMH (Anti Müllerian Hormone): AMH indicates the quantity of eggs. It is generated by the follicles, in the ovaries. When AMH levels are low it suggests an egg reserve despite menstrual cycles.

Knowing When to Consult a Doctor?

If you encounter any of these signs and they become more pronounced, it’s advisable to seek advice from a gynecologist or fertility expert. Detecting issues can open doors to various options such as IVF therapy or fertility preservation tailored to your preferences.

Causes of Diminished Ovarian Reserve

Several factors can contribute to a decline in ovarian reserve, including:

• Aging: Egg quality and quantity will decline by age. This is considered as the common cause of diminished ovarian reserve
• Genetic Factors: This can also be hereditary when X chromosomes get affected. Some women inherit these medical conditions, especially when their mother or grandparent experience early menopause.
• Autoimmune Disorders: Autoimmune oophoritis is a condition in which the immune system mistakenly attacks the ovaries. This can also lead to diminished ovarian reserve.

Medical Treatments:

• Surgeries: Surgeries done in the past, mainly ovarian cyst removal, can reduce the number of eggs produced.
• Chemotherapy and radiation therapy: Cancer treatments can also damage ovarian tissue. This leads to a decrease in egg count.

Lifestyle and Environmental Factors:

• Smoking: Consumption of Cigarettes, active and passive, increases ovarian aging rapidly and deplete eggs at a faster rate.
• Exposure to environmental toxins: Chemical particles found in pesticides, plastics and pollution may affect egg quality.

How to Test Ovarian Reserve?

If you suspect low ovarian reserve, several tests can assess your egg supply:

• Anti-Müllerian Hormone (AMH) Test: This test checks the levels of Anti Mullerian Hormone in the bloodstream showing how many eggs are left in the ovaries and can be conducted at any point during the menstrual cycle offering a reliable indication.
• Follicle-Stimulating Hormone (FSH) Test: This test is done on the 3^rd day of the menstrual cycle. This measures the levels of Follicle-Stimulating Hormone in the blood and also analyses ovarian function and egg quality, providing valuable information about ovarian reserve.
• Antral Follicle Count (AFC) via Ultrasound: This is done through ultrasound and is used to determine the quantity of follicles in the ovaries and gives an estimate of egg reserve levels. It is typically performed between days 2 to 4 of the menstrual cycle and assists healthcare providers in devising appropriate treatment plans for those seeking to achieve pregnancy.

If you’re planning to delay pregnancy, consider getting an ovarian reserve test early to evaluate your fertility potential.

Diminished Ovarian Reserve Treatment Options

Although diminished ovarian reserve can make conception more challenging, several treatment options can help improve fertility outcomes:

Ø  Lifestyle Changes & Supplements:

• Eat a healthy balanced diet including greens, leaves, berries, and nuts etc. This may help increase your ovarian health and egg count.
• Supplements and prenatal vitamins will also help improve egg quality.
• Involving in physical activities, exercise and stress management activities can also support reproductive health.

Ø  Freezing Your Eggs:

• Freezing eggs (known as oocyte cryopreservation) is a choice, to women looking to postpone pregnancy; it allows them to safeguard their fertility by preserving their eggs from an age, for later use.

Ø  Fertility Treatments

• When a woman has a number of eggs left in her ovaries, in vitro fertilization (IVR) could enhance the likelihood of getting pregnant. For women who have an ovarian reserve condition and struggle with conceiving through traditional methods, may find success in using donor eggs from a young and healthy donor to increase their chances of getting pregnant successfully.
• Ovarian PRP Therapy : An experimental method that includes the injection of platelet rich plasma (PRR ), into the ovaries to revitalize ovarian function.

Frequently Asked Questions

Is it still possible for me to conceive naturally if I have diminished reserve?

Yes indeed! It is possible to conceive under circumstances; however the likelihood is reduced significantly compared to situations in which conception occurs more readily with early detection and the utilization of fertility interventions leading to better results, in such cases.

What is the optimal age for egg freezing if I am dealing with reserves?

It’s best to consider fertility testing before reaching the age of 35 to determine the timing based on your ovarian reserve levels.

Can a healthy diet and supplements enhance function?

Eating well and taking some supplements can help with fertility. They may not have an impact on the number of eggs you produce in total. 

What treatment option is recommended for individuals, with reduced function looking to improve their fertility chances?

In vitro fertilization (IVF) can involve using either the mothers eggs or donor eggs based on the assessment of egg quality and quantity.

Get a Grip on Your Fertility!

When you grasp what diminished ovarian reserve entails you can make choices regarding your wellbeing, Curves and Kicks offers top notch treatment to help you achieve your goal of becoming a parent; consider scheduling a consultation with our fertility expert today.