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What Is Low Ovarian Reserve?
Low ovarian reserve is a condition in which the ovaries contain fewer eggs than expected for a woman’s age, or the eggs may be of reduced quality. This can make conception more difficult, especially when trying to become pregnant naturally.
All women are born with a limited number of eggs, and this reserve decreases over time. However, in some cases, the decline happens faster than normal or at a younger age. Low ovarian reserve doesn’t always mean infertility, but it may reduce future reproductive potential.
Causes and Risk Factors
Low ovarian reserve can result from various causes. Age is one of the most significant factors. After age 35, both the quantity and quality of eggs naturally begin to decline. However, other contributing factors may include:
- Family history of early menopause
- Previous ovarian surgeries
- Medical treatments such as chemotherapy or radiation
- Autoimmune disorders
- Endometriosis
- Smoking and lifestyle factors
In some cases, the cause of low ovarian reserve remains unknown.
How Is It Diagnosed?
Diagnosing low ovarian reserve involves a combination of hormonal tests and imaging. The most common assessments include:
- Anti-Müllerian Hormone (AMH): Measures the level of follicles in the ovaries. Low AMH may indicate reduced reserve.
- Antral Follicle Count (AFC): Performed via transvaginal ultrasound at the start of the menstrual cycle to count visible follicles.
- Day 3 FSH and Estradiol: Hormone levels measured early in the cycle to assess ovarian response.
No single test offers a definitive diagnosis, but together they provide a clearer picture of ovarian health.
Impact on Fertility and Available Options
Having low ovarian reserve doesn’t necessarily mean pregnancy is impossible, but it can present challenges. Timing becomes a critical factor, as response to fertility treatments may be limited.
Depending on individual circumstances, several strategies may be considered:
- Personalized ovarian stimulation to improve response in assisted reproduction cycles
- In vitro fertilization (IVF) adjusted for lower egg count
- Egg donation, especially when egg quality is severely affected
- Fertility preservation (egg freezing) in early stages of diminished reserve
Each decision depends on a thorough medical evaluation, patient age, and reproductive goals.
Emotional Considerations and Support
A diagnosis of low ovarian reserve can be emotionally difficult, often bringing feelings of urgency, anxiety, or sadness. Professional support and counseling can help patients understand their situation and make informed decisions calmly.
While the diagnosis may feel limiting, there are still paths forward. Understanding the condition, reviewing available options, and acting with clarity can make a meaningful difference in both the process and the outcome.