A Low Ovarian Reserve: What It Means and How to Beat It

Having a Low ovarian reserve means that women produce fewer good quality eggs during their monthly cycle suitable for fertilization and greatly diminishes your chances for conceiving. If your doctor says you have a low reserve, what they mean is that you have fewer good quality eggs available to be fertilized.

So What Are The Reasons Fo a Low Ovarian Reserve?

There are numerous reasons for this, it could be a result of high BMI (Body Mass Index), pelvic adhesions, prior ovarian surgery, or it could be age related, usually women in their late 30s or early 40s have a greater number of poorer quality eggs than good quality eggs. Smoking will affect egg quality, so will other health problems that have been previously treated with radiation therapy or chemotherapy. Also if you are effected by endometriosis this is also another factor of having a low ovarian reserve; having a low ovarian reserve is one of the leading factors of infertility and greatly diminishes your chance of conceiving, but it is not the end – not by a long way.

Looking at age, basically the younger you are the greater your chances of conceiving you have, with on average women up to 25yrs old have about a 40% chance of conceiving naturally, but conversely when you get to 40 your chances have fallen to round about 25%. So what this means is that your ovarian reserve is decreasing with age. What happens is that the poorer quality egg does not implant correctly in the uterus, once it has been fertilized or other eggs aren’t healthy enough to divide or grow and unfortunately may result in miscarriage.

How do you know if you have a low ovarian reserve?

You will need to see your doctor who will then refer you to a specialist and he will conduct several tests. The more usual tests and standard tests are by taking a blood sample to assess your egg quality; the doctor tests your blood usually as follows:

1. A day 3 FSH test; measuring your level of FSH, if it’s high this may indicate poor egg quality. If your FSH or estrogen hormone levels are elevated significantly (FSH >12) early in the cycle (day 2, 3, or 4) then you may take The Clomid Challenge Fertility Test.

2. The Clomid Challenge Test: This is another blood test looking for FSH as Estradiol; it is quite accurate and quite precise.

3. An AMH test. An AMH stands for Anti-Mullerian Hormone. The egg follicle that the ovaries grow to prepare an egg for release into fallopian tube produces AMH. The levels of AMH found in the blood could be an indicator of a woman’s ovarian function. Essentially, an AMH test can tell you if your ovaries are still releasing eggs.

4. A more in-depth test is the usual procedure implant an egg using IVF to see if it will grow or not or by having an IUI (Intra-Uterine Insemination).

The anti-Mullerian hormone (AMH) can be measured at any time in the menstrual cycle. It’s produced in the microscopic ovarian follicles where new eggs are created. As a woman ages, the number of these follicles diminish or get smaller and the amount of AMH circulating in the blood is thought to decline also. Doctors think that low AMH levels indicate a low reserve and that the result predicts how successfully a woman is likely to respond to fertility drugs that will hyper-stimulate her ovaries. Females with a low AMH scores are often poor responders to infertility treatments such as IVF & IUI. A high score, on the other hand, can be an indicator of polycystic ovarian syndrome (PCOS).

AMH is often measured on two different scales, one is the scale is measured in ng/ml (range runs from zero to about ten) while the other scale is pmol/l (range runs from zero to about 48). The normal range on the ng/ml scale is 2.2 to 4.0, although clinics may warn patients to not be excessively concerned if you are above, but always best to check.

Once the results are assessed then your doctor will advise you, if you do have a low ovarian reserve he will probably advise medications such as Clomid, but if your quality of eggs is too poor the doctor will probably advise use of an egg donor or try for adoption. But there are many women who have become pregnant with a low ovarian reserve or low egg quality.

How do other women get pregnant with a low ovarian reserve?

The options with this diagnosis will mean usually adjusting your life style, e.g. reducing alcohol intake, if you do smoke , then you do need to try to stop, try NRT (Nicotine Replacement Therapy), reducing your caffeine intake can also have a positive effect, plus following a really healthy diet (try organic meat and organic vegetables) and doing what thousands of women have done by getting pregnant with a low ovarian reserve, seeing a Chinese medical practitioner who will prescribe for you a range of special herbs to help improve blood flow entering into the uterus.

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