Ovarian reserve is a fundamental pillar for female fertility. The ability to conceive naturally is closely related to the quantity and quality of the eggs present in the ovaries, a reality that becomes even more important as time passes, as the chances of conception decrease with age.
Unfortunately, from a young age, we are taught to avoid pregnancy, but we are not informed about the natural limits of reproduction and female ovarian reserve.
In this regard, knowing your ovarian reserve will allow you to make informed decisions about your path to motherhood. So, if you want to know the status of your ovarian reserve and what your options are for getting pregnant now and in the future, here we explain everything related to it.
WHAT IS OVARIAN RESERVE AND WHY IS IT SO IMPORTANT?
Ovarian reserve refers to the quantity of eggs a woman has in her ovaries at a specific moment in her life. Over time, ovarian reserve decreases, especially from the ages of 31-35 onwards, directly affecting fertility and making natural conception more difficult.
While ovarian reserve does not guarantee fertility, its assessment can be a very useful indicator of the probability of conception, being especially important for fertility treatments, as it allows treatment to be personalized based on each person’s situation.
Additionally, for women who wish to postpone motherhood for social reasons or due to illnesses requiring aggressive treatments, it is a good indicator of the steps to follow. Without hesitation, preserving eggs nowadays is an excellent choice to provide reproductive options for the future in these young women.
WHAT FACTORS INFLUENCE OVARIAN RESERVE?
Ovarian reserve is primarily related to biological and genetic factors, and its decline is a natural process that occurs with aging. However, it can also be affected by other factors such as smoking, exposure to certain chemicals, surgery, ovarian disorders, medical treatments like radiotherapy or chemotherapy, hormonal factors, or diseases such as endometriosis or autoimmune diseases.
Although some of these factors are not modifiable, measures can be taken to improve overall reproductive health, such as maintaining a healthy lifestyle and controlling stress and toxins.
HOW TO EVALUATE YOUR OVARIAN RESERVE?
Now that you understand the importance of ovarian reserve, it’s time to answer the key question: how can you know the status of your ovarian reserve? There are different ways to assess ovarian reserve. Below, we explain the most common ones.
1. HORMONE TESTS
Undoubtedly, measuring the Anti-Müllerian Hormone (AMH) level through a blood test is the best indicator of ovarian reserve. For this hormone extraction, you do not need any prior preparation and you can even do it while taking your usual contraceptive pill without discontinuing it.
Other hormonal values such as FSH at the initial stage of the cycle can also be measured, but the latter may present a lot of fluctuation and is not the hormone of choice today.
2. ANTRAL FOLLICLE COUNT
An additional way to assess ovarian reserve, apart from the blood test, is through a transvaginal ultrasound to count the antral follicles. Follicles are like “houses” where eggs are found in their different stages. We observe the follicles because the eggs are microscopic and cannot be seen on a monitor due to its resolution limit.
ARE THERE SPECIFIC TREATMENTS FOR WOMEN WITH LOW OVARIAN RESERVE?
Yes, there are specific treatments for women with low ovarian reserve, although it is important to note that the effectiveness of these treatments may vary depending on individual situations, age, and other causes in the couple that lead to having to perform an assisted reproduction technique. Some options are as follows:
- In Vitro Fertilization (IVF) with own eggs: ovaries are stimulated with hormonal treatment with ultrasound monitoring aiming for a greater number than the natural physiological one. Subsequently, they are surgically extracted and fertilized in a laboratory.
- Intracytoplasmic Sperm Injection (ICSI): here, the ovaries are also hormonally stimulated, and ICSI is a technique where a sperm is injected directly into a mature egg to achieve fertilization. Nowadays, it is the preferred technique.
- Stimulation under double stimulation protocols (DUOSTIM): with the aim of accumulating more oocytes to perform ICSI. Stimulating in different stages of the woman’s cycle the production of eggs.
- Egg donation: for some women with low ovarian reserve, egg donation may be an option, which involves using eggs donated by another woman (young donor) to perform ICSI.
- Adjuvant ovarian rejuvenation therapies and others to improve ovarian response: adjuvant drugs, PRP, etc. However, the effectiveness of these treatments may vary, and many studies are still needed to confirm their scientific effectiveness.
