Have you been trying to conceive for a long time? It's normal to feel sad and anxious when you don't get results as quickly as you thought. Your doctor may have told you that your ovaries have a low egg reserve, a condition called Diminished Ovarian Reserve . That's what we're going to talk about today. Don't worry, understanding this properly will help you a lot.
What is Diminished Ovarian Reserve?
Simply put, Diminished Ovarian Reserve is when the number of eggs in your ovaries decreases compared to other people your age. This is sometimes called a "low egg count." You know, in order to get pregnant, you need an egg (along with a sperm). Normally, everyone's egg count decreases as they get older. It's natural. However, for some people, this happens sooner than expected. That's when this condition occurs.
Having a baby can be a little more difficult when your egg reserve is low. Your doctor can tell for sure if you have this condition by performing a test called Ovarian Reserve Testing .
The important thing is that this doesn't mean you can never have a baby. However, it may be a little more difficult, or you may need to resort to fertility treatments.
How many eggs should we normally have in our ovaries?
Think about it, when we girls are born, we get all the eggs we need for our entire lives. After that, no new eggs are produced. Your age is the main factor that determines how many eggs you have. Studies have shown that after the age of 35, the rate of egg loss increases even more.
Although these numbers may vary from person to person, here's an idea of the average number of eggs we have throughout our lifetime:
- At birth: Between 1 and 2 million eggs.
- At puberty: Between 300,000 and 400,000 eggs.
- Around age 40: About 25,000 eggs.
- At menopause: Fewer than 1,000 eggs.
However, only your doctor can tell you exactly how many eggs you have, after reviewing the results of the aforementioned Ovarian Reserve Testing.
Is it impossible to have a child because you have few eggs?
You can't say no! You can still have a baby even if you have a low egg count. However, you should also understand that the chance of getting pregnant may be slightly lower due to the low egg count. Think about it, all you need to make a baby is a good, healthy egg, right?
Also, it's not just the number of eggs that are needed to conceive a child. There are many factors that affect this, including the quality of the eggs , the quality of your partner's sperm, and the health of your uterus and fallopian tubes.
What are the symptoms of this condition?
Most people don't show any specific symptoms. The only thing is that they can't get pregnant after months, maybe years, of having sex (without using any birth control).
Some women may start to have their periods earlier than usual, meaning their cycles become shorter and the number of days shorter.
If you have Primary Ovarian Insufficiency , a condition in which the ovaries are not functioning properly, you may experience symptoms during perimenopause . These include:
- Sudden sweating and feeling hot (hot flashes).
- Irregular menstruation (early, late, or missing for months).
- Vaginal dryness, which can cause discomfort during intercourse.
Why is this happening? What are the reasons for this?
Aging is the main and natural cause of decreased egg reserve. It is common for everyone. However, sometimes no clear cause can be found.
There are other reasons that can affect this:
- Genetic conditions: Genetic problems, especially those involving the X chromosome.
- Cancer treatment: Radiation or chemotherapy for cancer can damage the ovaries and destroy eggs.
- Surgeries performed on the ovaries: Some surgeries require the removal of part of the ovaries.
- If one or both ovaries have been removed: This may be necessary due to a medical condition.
- Autoimmune conditions: This is when our body's own immune system attacks our own ovaries.
Does stress affect this?
No, stress does not directly reduce egg reserve. Many people have a misconception about this. However, according to the American Society of Reproductive Medicine, smoking and the use of tobacco products (cigarettes, bidis, etc.) are the only lifestyle factors that have been found to reduce egg reserve.
What tests are available to detect this?
Doctors use a group of tests called Ovarian Reserve Testing to get a rough idea of how many eggs are left in your ovaries.
However, these tests cannot tell you exactly how long you will be able to have children, or whether you will be able to get pregnant naturally (without any treatment). These tests mainly look at how your ovaries respond to hormonal drugs used in fertility treatments such as IVF (In Vitro Fertilization) , or whether you are less likely to get pregnant without treatment.
It is very important to note that even if these tests confirm that you have low egg reserves, it does not mean that you cannot have a child naturally. These tests do not measure your natural fertility.
Ovarian Reserve Testing usually includes:
- Blood tests: This involves taking a sample of your blood and checking the levels of hormones called (Anti-Mullerian Hormone - AMH) , (Follicle-Stimulating Hormone - FSH) , and (Estradiol) . These hormone levels can give your doctor an idea of how your ovaries are responding to fertility drugs.
- Vaginal Ultrasound: This involves inserting a small scanning device through the vagina to measure the size of the ovaries. It also measures the number of tiny follicles inside the ovaries that can contain eggs. This is also called the Antral Follicle Count (AFC) .
- There is a test called the Clomiphene Citrate Challenge . This involves taking an oral fertility drug (Clomiphene Citrate) for a few days, then measuring hormone levels and seeing how the body responds to it. However, this test is not used very often anymore.
Those with low ovarian reserve typically have higher (FSH) hormone levels than others their age, lower (AMH) hormone levels, and lower (AFC). Again, these tests mainly measure how your ovaries respond to hormonal medications, not your ability to get pregnant without medication.
What can be done as treatment?
This is the most important thing we need to understand first: According to current medical science, there is no way to reverse the decline in egg reserves or to create new eggs in the ovaries.
If your doctor suspects this condition, he or she will talk to you carefully and help you create a treatment plan that will help you achieve your dream of having a child. When creating this treatment plan, the doctor will ask you questions like:
- How soon would you like to have a baby?
- How many children do you want?
- How are your financial capabilities? (Some treatments can be expensive)
- Do you want a child who is genetically related to you , or are you willing to consider other options?
Treatment options are determined by considering all of these factors. The main options are:
- Freezing your eggs for future use.
- Trying to get pregnant naturally (can take a while).
- IVF (In Vitro Fertilization) treatment - You can use your own eggs, or you can use donor eggs (eggs obtained from someone else).
If you use your own eggs...
Egg freezing is a great way to preserve your fertility. Especially if your doctor thinks you're at high risk of low egg count, they may suggest freezing your eggs before they become too low.
What happens is, you are given hormone injections to stimulate your ovaries to produce as many eggs as possible at once. Then, these mature eggs are retrieved through a minor surgical procedure and frozen in a special way for future IVF treatment.
Sometimes, your doctor may suggest creating embryos (the first cells that form when an egg and sperm come together). This means that mature eggs are taken, fertilized in a lab with your partner's sperm or with donor sperm (sperm from someone else), and the resulting embryos are frozen for future use. Or, they can be transferred to your uterus and implanted right away.
If you are using donor eggs...
If the quality and/or quantity of your eggs is very low, meaning that the chances of a successful pregnancy using your own eggs are very low, your doctor may suggest using donor eggs (eggs donated by another healthy woman).
In this case, an egg from a donor is fertilized in a laboratory with your partner's sperm (or donor sperm). The resulting embryo is then implanted in your uterus. The baby created this way will not inherit your genes, but it may inherit your partner's genes (unless donor sperm was used).
Another option is embryo freezing. This involves fertilizing your eggs (or donor eggs) with sperm, creating an embryo, and freezing it for future use.
Does folic acid improve egg quality?
There are special vitamins to take during pregnancy (Prenatal vitamins), which contain a vitamin called Folic Acid . This (Folic Acid) is very important for maintaining the quality of eggs.
If you're hoping to have a baby, your doctor will probably tell you to start taking a prenatal vitamin. It's best to start taking it at least three months before you plan to conceive . This is because it takes about three months for an egg to fully mature.
Your diet, exercise, and other lifestyle factors (like not smoking) can affect the health, or quality, of your eggs. However, they don't affect the number of eggs you have or your ovarian reserve (a condition called Diminished Ovarian Reserve).
What can we do to reduce this risk?
Honestly, there's nothing you can do to prevent your egg supply from decreasing. As we've discussed before, there are many factors that affect this, including things that are beyond our control (like aging and genetics).
However, there are some things you can do to help keep your egg quality as good as possible. For example:
- Maintaining a healthy body weight.
- Staying completely away from tobacco products like cigarettes.
Although these things will not increase the number of eggs, they will help maintain the quality of the eggs that are available.
How successful is IVF treatment for those with low egg reserves?
The success of IVF (In Vitro Fertilization) treatment varies greatly from person to person. It depends on many factors, including the cause of your low egg count, the number of eggs you have, the quality of those eggs, and how your body responds to fertility drugs.
It's difficult to provide exact statistics on the success rate of IVF for those with low egg reserves, as it depends on many factors.
But researchers do know that, like natural pregnancies, the success rate of IVF decreases with age. This is especially true for those with low egg reserves. The older you get, the less successful your IVF may be.
If tests show that your egg supply is low, you are less likely to respond well to hormonal drugs (which stimulate the ovaries). This means that you may not be able to collect as many eggs as you would like during IVF. However, IVF may be the best option for you. You should definitely talk to a fertility specialist (a doctor who treats infertility) about this and decide what is best for you.
Does decreasing ovarian reserve mean menopause is approaching?
It's hard to pinpoint exactly when menopause (the time when your periods stop completely) will begin. Low ovarian reserve only means that your egg supply is decreasing. While it can be a sign of menopause, it's not possible to predict exactly how soon it will occur.
Finally, something for you to consider...
When you hear from your doctor that you have a reduced ovarian reserve, you may feel very disappointed, sad, and worried about what the future holds. This is very normal, and you don't need to feel bad about it.
But, the most important thing is to remember that it is still possible to get pregnant despite this condition. So don't be discouraged or give up hope.
Your doctor can take into account the number of eggs you have left, your age, and your health, and create the best treatment plan to help you achieve your dream of having a child. There are also other options, such as fertility treatment and, if necessary, using donor eggs.
Don't give up on your dream of having a child just because your egg supply is low - there are definitely treatments and methods to help you. Talk openly with your doctor and choose what's best for you.
` Ovaries, egg depletion, infertility, pregnancy, women's health, IVF, fertility
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