Diminished Ovarian Reserve – Everything You Need to Know About

“Ovarian reserve” refers to the quality and number of eggs. They are also known as “Oocytes”. The average number of eggs in ovarian reserve depends upon age.

Eggs are formed in a female while she was still in utero. Thus, a female is born with all the eggs. From this stage, the number of eggs starts to decline.

On average, these are the number of eggs most women have in different age groups.

·         20 weeks of Gestation: 60 lakhs to 70 lakhs oocytes

·         Birth: 10 lakhs to 20 lakhs oocytes

·         Puberty: 3 lakhs to 5 lakhs oocytes

·         Around age 37-38: Approximately 25,000 oocytes

·         around age 50-51: Approximately 1,000 oocytes

This decrease of ovarian reserve is typically known as “Diminished Ovarian Reserve” or DOR.

In this article, we shall understand what Diminished Ovarian Reserve is andvarious aspects related to it.

 

Diminished Ovarian Reserve

Diminished Ovarian Reserve is a term used to specify a condition in which a woman has a low count and low quality of eggs in her ovaries.

This condition can be depressing as it can lead to difficulty for women to conceive or even cause infertility.

However, different fertility options can help women with DOR to become pregnant.

 

Causes

While normal ageing is the primary causefor DOR, there are other factors involved as well. Let’s check them out.

·         Smoking

·         Tubal disease

·         Endometriosis

·         Genetic disorders (Fragile X and other X chromosome abnormalities)

·         Aggressive radiation treatments (For example, radiation for cancer)

·         Ovarian surgery, such as endometriosis

·         Idiopathic

·         Pelvic infection

·         Autoimmune illnesses

·         Mumps

In certain cases, there is no apparent cause for this disorder.

 

Symptoms

There aren’t many visiblesymptoms for DOR. However, the following symptoms may be noticed by women suffering from DOR.

·         Difficulty in getting pregnant

·         Heavy menstrual flow

·         Shorter menstrual cycles

·         Miscarriage

·         Late or lack of menstrual periods

However, these symptoms aren’t always noticeable. This is the reason why you must consult your healthcare provider if you are having difficulty conceiving.

 

Diagnosis

With an early diagnosis of the condition, there are better chances of having a successful treatment. Here are a few tests that can be performed for diagnosing DOR.

·         AMH testing: Measuring AMH (anti-Müllerian hormone) levels can be extremely helpful in evaluating diminished ovarian reserve. AMH values that are more than 1.0-1.2 are generally accepted as normal.

 

AMH is produced by eggs in the ovaries and specifies how many eggs will remain in them. As ovarian functioning reduces, AMH production declines too.

 

·         FSH testing: In this test, the doctor measures FSH (follicle-stimulating hormone), which is produced by the pituitary gland in the brain and is measuredon third day of a woman’s menstrual cycle.

 

As ovarian function declines, FSH production surgesto trigger the ovaries to develop eggs. Testing FSH levels on day 3 can give you precise reading.

 

Most healthy women that lie in the childbearing age group have FSH values below 10. A value of 10 indicates a decline in ovarian reserve.

 

·         Transvaginal ultrasound: Transvaginal ultrasound lets an expert check and count a woman’s antral follicles (the egg-containing pockets in the ovaries) at the start of her menstrual cycle.

 

Antral follicles can tell the number of retrievable eggs in ovarian stimulation, a procedure used in many fertility treatments.

 

These tests in combination can help to detect DOR with higher certainty.

 

 

Treatment Solutions

As of now, there are no treatments available that can prevent or stop ovarian ageing. However, once DOR is diagnosed, different assisted reproductive technologies can help women to conceive.

 

·         Ovarian stimulation: This treatment is an exaggerated form of ovulation induction.

 

It utilises injectable hormones to induce the woman to ovulate multiple eggs. The eggs are then collected for cryopreservation or for use in a fresh IVF cycle to develop an embryo and implant it in the woman’s womb.

 

·         Fertility preservation: A woman suffering from DOR can take an immediate step and try fertility preservation. This treatment involves retrieving a woman’s eggs from ovaries and then freezing them.

 

The best time for women to freeze eggs is when their ovarian reserve is better and they are young.

 

·         Donor eggs: Donor eggs in combination with IVF are the best solution for women with DOR, especially if the eggs are of low quality.

 

A woman can become pregnant using the donor eggs fertilized by her partner’s sperm (or donated sperm) and get the embryo implanted in her uterus.

 

 

Conclusion

Once the diagnosis for DOR is performed, the prognosis for women with this condition is secured.

We understand that a woman can feel discouraged from being told that she has diminished ovarian reserve. However, with the right fertility treatment, it’s completely possible to get pregnant. 

If you suspect whether you have diminished ovarian reserve or not, or if you are having difficulty getting pregnant, you must consult a fertility specialist.

Disclaimer:

Though all attempts are made to provide correct information on the subject, inadvertent & typographical errors arising out of manual intervention cannot be ruled out. It is requested to bring any such discrepancies to the notice of the blogger for correction.