Do You Have A Diminished Ovarian Reserve?
Women hoping to become potential parents may have infertility challenges. Infertility occurs when potential parents are unable to conceive after at least 12 months of unprotected intercourse. A possible reason is a diminished ovarian reserve (DOR), where the ovaries lose reproductive potential. DOR means the ovaries struggle to produce the required eggs for pregnancy. There is no way to replenish the ovarian reserve, but strategies like in vitro fertilization (IVF) can maximize the chances of a successful pregnancy.
The key aspects of DOR
Women with a diminished ovarian reserve have a reduced egg count. Women are born with around 1-2 million follicles, which gradually declines. By puberty, roughly 25% remain. A diminished reserve means a woman has considerably fewer follicles relative to age. The remaining eggs may also be of lower quality, having a higher likelihood of chromosomal abnormalities. As a result, women with DOR may struggle to get or stay pregnant. Some even experience earlier signs of menopause.
What causes a diminished reserve?
Ovarian health changes over time. Some women experience a more rapid decline in ovarian reserve than others. Age is undoubtedly the most significant cause of DOR. The ovarian reserve is expected to decline, but some women have significantly fewer follicles at an advanced reproductive age. There may be a genetic relationship, as a parent or family member may have experienced DOR. External factors like smoking, previous ovarian surgery, chemotherapy, and radiotherapy can damage the ovaries. While maintaining general health helps, there is no way to predict if DOR will develop.
Diagnosis and treatment
DOR shows no real symptoms besides difficulty conceiving. A blood test can help measure hormones like anti-mullerian hormone (AMH) to gauge current ovarian reserves. An antral follicle count performed via ultrasound can also confirm DOR. The doctor will explain the results and the best course of action for women hoping to get pregnant in the future. Some doctors will try a form of controlled ovarian hyperstimulation (COH) by using hormone medication to get the ovaries to produce multiple follicles. Intrauterine insemination (IUI) is then used to attempt pregnancy. Hormone medication is also used to create multiple follicles for cryopreservation. Preserving eggs can help women attempt pregnancy later.
Why IVF is your best chance
Ovulation induction or COH may not produce immediate results. Some women with DOR may need a more controlled, accurate approach to achieving pregnancy. IVF is the best option for circumventing DOR. With IVF, the fertility team can take multiple follicles and create embryos with a sperm sample. The embryos can undergo genetic testing to discover the most viable options. Fertility doctors then transfer a single embryo to the uterus for pregnancy. Sometimes, women may require donor eggs if the DOR fails to produce viable eggs. Combining donor eggs with a partner’s sperm ensures there is still a biological link to the intended parents. This process has high success rates and maximizes the chances of pregnancy.
A deeper understanding of DOR
The ovarian reserve is a delicate, complex part of the reproductive system. Science and medicine continually strive to understand the inner workings of the ovarian reserve to provide better solutions to challenges like DOR. IVF is the most effective treatment option. There is more control and predictability in achieving pregnancy. However, time is of the essence. Seeking advice and guidance from a fertility specialist ensures women can attempt different treatments quickly and benefit from strategies like IVF sooner.
