The journey toward parenthood can be an exciting but challenging time for many couples, especially when faced with fertility issues. One such condition that can affect a woman’s ability to conceive is low ovarian reserve (LOR). This condition refers to a reduced number of quality eggs in the ovaries, which can make it harder to achieve pregnancy. Understanding LOR, its causes, symptoms, and treatment options can help individuals navigate the complexities of fertility and make informed decisions about their reproductive health.
What is Ovarian Reserve?
Ovarian reserve refers to the number of eggs a woman has in her ovaries at any given time, along with the quality of those eggs. Women are born with a finite number of eggs, approximately 1-2 million at birth. As a woman ages, the number of eggs naturally declines, with about 300,000-400,000 remaining by the time she reaches puberty. Over the years, this number continues to decrease, with only a fraction of those eggs being of high enough quality to support conception.
What is Low Ovarian Reserve?
Low ovarian reserve occurs when the number of eggs remaining in a woman’s ovaries is lower than expected for her age. Typically, women in their 20s and early 30s have a healthy ovarian reserve, but this reserve gradually diminishes with age, especially after 35. Women with LOR have fewer eggs available for fertilization, which reduces the likelihood of getting pregnant, either naturally or with assisted reproductive technologies like in vitro fertilization (IVF).
Causes of Low Ovarian Reserve
Several factors contribute to a woman’s ovarian reserve. Some of these factors are controllable, while others are determined by genetics or lifestyle choices. The primary causes of low ovarian reserve include:
Age: Age is the most significant factor in ovarian reserve. Women over 35 experience a natural decline in both the quantity and quality of eggs, making it harder to conceive.
Genetics: Some women may be genetically predisposed to having a lower ovarian reserve than average, regardless of their age.
Medical conditions: Autoimmune disorders, endometriosis, or prior ovarian surgeries can negatively impact ovarian reserve.
Lifestyle factors: Smoking, excessive alcohol use, or exposure to environmental toxins can accelerate the decline in ovarian reserve.
Chemotherapy or radiation therapy: Treatments for cancer can damage the ovaries and reduce the number of viable eggs.
Premature ovarian insufficiency (POI): Also known as premature ovarian failure, POI can occur in women under 40 and is often caused by autoimmune disorders, chromosomal abnormalities, or unknown factors.
Symptoms of Low Ovarian Reserve
Unlike other health conditions, low ovarian reserve does not typically present with clear or immediate symptoms. However, there are a few signs that may indicate diminished ovarian function:
Irregular menstrual cycles: Women with LOR may experience shorter or irregular menstrual cycles, which can signal hormonal changes.
Difficulty conceiving: One of the primary indicators of LOR is difficulty in achieving pregnancy after trying for six months to a year.
Family history: If a close relative, such as a mother or sister, experienced early menopause or fertility issues, there may be a genetic predisposition to LOR.
Diagnosis of Low Ovarian Reserve
If a woman suspects she has low ovarian reserve or is having difficulty conceiving, a fertility specialist can run diagnostic tests to assess her ovarian function. Common tests include:
Anti-Müllerian Hormone (AMH) Test: AMH is produced by the follicles in the ovaries. Higher levels of AMH indicate a healthy ovarian reserve, while lower levels suggest diminished ovarian function.
Antral Follicle Count (AFC): An ultrasound can count the number of small follicles in the ovaries, providing an estimate of how many eggs are left.
Follicle-Stimulating Hormone (FSH) Test: FSH levels rise when the ovaries are struggling to produce eggs. High FSH levels can indicate low ovarian reserve.
Can You Get Pregnant with Low Ovarian Reserve?
While having low ovarian reserve can make it harder to conceive, it does not mean pregnancy is impossible. Women with LOR can still conceive, either naturally or with the help of fertility treatments. However, the success rates for conception may be lower, and additional support may be necessary.
Acupuncture can help to improve egg quality to assist getting pregnant quickly.
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Low ovarian reserve can pose challenges for women who are trying to conceive, but it does not close the door on pregnancy. With advancements in fertility treatments and personalized medical care, many women with LOR are able to conceive and have healthy pregnancies. Understanding ovarian reserve, seeking early diagnosis, and exploring available treatment options are key steps in taking control of fertility and making informed decisions about family planning.
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