Low Ovarian Reserve: Causes, Treatment, Diagnosis
What Does Having a Low Ovarian Reserve or Poor Ovarian Reserve Mean?
Every female right at the time of her birth has certain amount of eggs present in her ovaries which is termed as the Ovarian Reserve. This Ovarian Reserve diminishes with the passage of time but at any given point in time there are enough eggs in the ovaries required to easily reproduce when the female reaches the reproductive stage. In some females, this reserve of eggs or in other words the pool of eggs present in the ovaries is low than what the normal is. Such females are said to have a Low Ovarian Reserve. Such females find it difficult to get pregnant due to the low number of eggs present in their ovaries. This is usually the case in females above the age of 35 who try to get pregnant. Having a Low Ovarian Reserve does not mean that the patient has a dysfunctional ovary as ovarian function is not dependent on the number of eggs it has. Now, the important question to ask here is that what happens to all the eggs that were present previously. As stated, when a female is born, she is estimated to carry millions of eggs in her but with passage of time due to natural aging a lot of these eggs decay even before the female reaches the reproductive age. It is estimated that above the age of 35, a female has approximately about 30,000 eggs which further declines when the female reaches menopause. Under normal circumstances, the eggs present in a female is grouped into three categories of which one is a collection of immature eggs, one is a group of matured eggs which are ready for ovulation, and one is a group of dead eggs. Every month, there is a certain percent of eggs that get matured to ovulate of which one egg gets ovulated and the rest die and are reabsorbed by the ovary.
What are the Causes of Low Ovarian Reserve?
When it comes to the cause of a Low Ovarian Reserve, literature suggests that it can be caused by certain abnormalities in the chromosomes which can be seen in disease conditions like Turner Syndrome. Low Ovarian Reserve can also be caused due to partial or complete removal of an ovary, presence of ovarian cysts, or tumors both benign as well as malignant of the ovaries. Obese females are also at risk for having a Low Ovarian Reserve.
What is the Impact of a Low Ovarian Reserve on Fertility?
Having a Low Ovarian Reserve indicates that the patient will have less of a chance of getting pregnant, although it does not indicate that the female will never get pregnant. There are quite a few methods available these days which are quite helpful for females with Low Ovarian Reserve to get pregnant.
What are the Different Tests to Diagnose Low Ovarian Reserve?
The best way to check whether a patient has a Low Ovarian Reserve which is used widely is the Follicle Stimulating Hormone or FSH test. Ultrasound is also a method to check whether a female has a Low Ovarian Reserve. The FSH test is done by doing a blood test on the second or third day of the menstrual cycle. The FSH is a hormone which is released by the pituitary gland and stimulates the ovaries to start maturing the eggs of which one egg eventually ovulates. In case of a Low Ovarian Reserve, the FSH level will be higher, even though the test results may not always be accurate.
What is the Treatment for Low Ovarian Reserve?
At present, there are several treatments available which assist in getting a female with a Low Ovarian Reserve to get pregnant. The most important factor to consider here is whether you want a child which has your DNA or not. A therapy known as oocyte donor therapy has quite a high success rate and you can still have a baby which will have the DNA of the partner but the success of this therapy depends on whether your uterus is strong, healthy, and receptive. In case if you go for fertility treatments, then a major factor to consider here is how psychologically and financially strong you are, as there may be multiple failed attempts at getting pregnant. If an IVF is planned and executed properly you can get remarkable results and get pregnant despite having poor screening results and having a Low Ovarian Reserve.