Poor Ovarian ReserveNo comments yet drpankajtalwar July 12th, 2019
Are You Having Infertility?
Have you been Diagnosed with Low Egg Count?
Ovarian reserve is a theoretical concept. As a practical matter, it refers to the ease at which an individual’s ovaries can be successfully stimulated with fertility drugs. It indicates quantity and quality of oocytes in women of reproductive age group.
The single most consistent variable affecting ovarian reserve is the woman’s age. This is because a woman is born with all the eggs she will ever have.
In most women majority of the eggs are genetically normal or balanced. However, there will be some that are genetically abnormal or unbalanced.
It appears that the best eggs are ovulated first. The older a woman is, the fewer genetically balanced eggs she has left to respond to fertility drugs. This age relationship holds true even in the fertile population.
It indicates a reduction in quantity and quality of oocytes in women of reproductive age group.
An AFC (antral follicular count) of 4 put together in both the ovaries and serum AMH value of less than or equal to 0.28ng/ml is considered to be indicative of decreased ovarian reserve.
There is a risk of Low pregnancy rates irrespective of age and a high pregnancy loss.
Any of the two criteria out of three should be present to diagnose poor ovarian reserve:
- Advanced maternal age (>or= 40yrs of age) or any other risk factor for poor ovarian reserve.
- A previous poor ovarian reserve (
- An abnormal ovarian reserve testing (AFC ,5-7 follicles or AMH ,0.5-1.1ng/ml)
Reproductive aging is a continuous process from before birth till menopause. Throughout reproductive life there is a progressive and irreversible loss of the eggs which apart from natural age related decline, certain factors may further deplete the ovarian reserve like endometrioma, certain pelvic infections, ovarian surgery, chemotherapy ,radiotherapy, etc . So the ovarian reserve reduces early and patient may have early menopause also.
The management of poor ovarian reserve patients is challenging, pregnancy rates are very low with simple forms of treatment, and IVF in such women offers the highest probability of pregnancy and antagonist protocol is most preferred one. When repeated attempts at treatment become unsuccessful, the only options that remain are recourse to oocyte donation or adoption.
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