What Does Low Ovarian Reserve Mean? | Signs, Causes and Symptoms

Does Low Ovarian Reserve Affect My Fertility?

Your fertility journey may have its ups and downs.

But one such roadblock can have something to do with the quantity of eggs in your ovaries.

That hurdle is a diminished ovarian reserve (DOR), meaning a lower-than-expected number of eggs or compromised egg quality.

But does that mean you can’t get pregnant naturally?

In fact, let’s keep the fear mongering away from this one. Low ovarian reserve does not mean that you cannot get pregnant.

So what can you do if you’re diagnosed with low ovarian reserve? Is there any way to improve it?

That’s exactly what we delve into, with this article! Read on!

What is diminished ovarian reserve?

Women are born with a limited number of eggs that gradually decrease throughout their life. This reserve reduces over time, making pregnancy more challenging.

At birth, a baby girl has around one million immature eggs stored in tiny sacs within the ovaries. By puberty, this number drops to about 300,000. As a woman ages, especially in her mid-thirties, the number of eggs continues to decline.

Over time, that ovarian reserve diminishes. For some women, though, it can happen at an accelerated rate for various reasons.

What causes diminished ovarian reserve?

There’s no single cause behind diminished ovarian reserve but rather a mix of causes such as:

1. Age: The primary cause of DOR is age-related. As women age, their ovaries naturally produce fewer eggs, and the quality of the remaining eggs declines. This is because women are born with a finite number of eggs, and over time, they are released or absorbed by the body.

2. Genetics: Genetic conditions like Turner syndrome, Fragile X syndrome, and certain X chromosome abnormalities can affect ovarian function and lead to DOR. These conditions can alter how the ovaries develop or reduce the number of eggs a woman is born with.

3. Autoimmune diseases: Certain autoimmune diseases, like lupus, can attack healthy tissues in the body, including the ovaries. This can damage egg follicles and reduce egg quality.

4. Endometriosis: Endometriosis, a condition where endometrial tissue grows outside the uterus, may be linked to DOR. The exact reason for this association is unclear, but theories suggest that endometrial tissue may release substances that suppress ovulation or affect egg quality.

5. Past medical treatments: Medical treatments for cancer, such as chemotherapy and radiation therapy, can damage the ovaries and reduce egg reserve. The severity of the impact depends on the type and dosage of treatment, as well as a woman's age at the time of treatment. Hence, egg freezing to preserve egg quality is often recommended prior to chemotherapy.

6. Lifestyle: With lifestyle, smoking is one such factor that can harm your fertility and the health of your eggs. Studies suggest that women who smoke may experience menopause earlier compared to non-smokers.

What are the symptoms of diminished ovarian reserve?

Reduced egg reserve often doesn't cause any noticeable symptoms. The only indication might be difficulty conceiving despite trying for a while.

However, some women may experience irregular or infrequent menstrual periods. As DOR progresses, periods may become lighter or stop altogether, signaling approaching menopause.

These can include shorter menstrual cycles (like going from 28 days to 24 days), irregular periods, vaginal dryness, hot flashes, and sleep disturbances. If you're concerned about your fertility or experience these changes earlier than expected, consult your doctor.

Most women naturally reach menopause between their 40s and late 50s. However, a small percentage (around 1%) experience menopause earlier, before the age of 40. This condition is known as premature ovarian failure or premature menopause.

What are the tests for diminished ovarian reserve?

There are several different tests for diminished ovarian reserve. The two most common are blood tests, along with ultrasound:

1. Follicle-Stimulating Hormone (FSH): FSH is a hormone produced by the pituitary gland that stimulates the ovaries to develop follicles, which contain eggs. In women with DOR, FSH levels tend to be elevated. An FSH (follicle stimulating hormone) level greater than 20 IU/mL indicates low ovarian reserve. This happens because the body is trying to increase FSH production to compensate for the declining ovarian function and stimulate egg development.

2. Anti-Müllerian Hormone (AMH): AMH is a hormone produced by developing follicles in the ovaries. AMH levels tend to be lower in women with DOR as they reflect the remaining pool of eggs. A low AMH level indicates a lower egg reserve.

3. Pelvic Ultrasound: This imaging test uses sound waves to create a picture of the ovaries. The doctor can assess the size and appearance of the ovaries and measure the antral follicle count (AFC). AFC refers to the number of small follicles (antral follicles) visible on the ultrasound. A low AFC can indicate a diminished egg reserve.

If these tests suggest a lower egg reserve, it may affect your chances of getting pregnant naturally. However, it’s important to remember that this doesn't entirely rule out your chances at conceiving naturally.

Can I increase my ovarian reserve?

While an egg reserve test result might indicate a lower chance of conceiving naturally, a low ovarian reserve is just one piece of the fertility puzzle. Your age, overall health, and other reasons could also play a role in your fertility.

Ovarian PRP

On the clinical end, there’s ovarian PRP. This emerging technique utilizes platelet-rich plasma (PRP) derived from your own blood and injected into the ovaries.

Early research suggests PRP may improve ovarian function and increase pregnancy rates in women with DOR, but more studies are needed for conclusive evidence.

Supplements

While there's currently no definitive way to increase your egg reserve, some supplements may come with some potential benefits to support ovarian function.

Some options have shown promise in early studies, and we'll delve into the most popular ones:

• DHEA: Dehydroepiandrosterone is a hormone that is produced naturally by the adrenal glands. This study suggests an improvement in ovarian function and increased AMH levels however, more research is required to confirm these effects.

• CoQ10: An antioxidant naturally present in the body. While some claim it improves egg quality and AMH levels, scientific evidence is limited.

• Vitamin D: Studies suggest a Vitamin D deficiency could be linked to low AMH levels and as a result supplementing Vit D may help improve AMH levels if you are deficient.

  
  

Lifestyle and health

There's no single guaranteed diet to increase your ovarian reserve. However, focusing on a healthy overall diet can benefit your fertility. Here are some key points:

• Nutrient powerhouse: Include plenty of zinc-rich foods like oysters, colorful fruits and vegetables for antioxidants, and omega-3 rich fish like salmon. Nuts and seeds offer Vitamin E, another important factor.

• Mediterranean approach: Consider incorporating a Mediterranean diet rich in vegetables, healthy fats, and fish – studies suggest it might be helpful.

Lastly, talk to your doctor for a personalized plan to ensure you get the right nutrients for optimal reproductive health.

Arva’s take on battling low ovarian reserve

For women diagnosed with DOR, egg freezing offers a potential path to future parenthood. By freezing their eggs when they are younger and healthier, women with DOR can preserve their fertility.

Later, when they decide to conceive, the frozen eggs can be thawed, fertilized with sperm, and used in in vitro fertilization (IVF) or ICSI for pregnancy. If you're concerned about diminished ovarian reserve, Arva can be your helpful guide. With our fertility tests , you can get an insight into your ovarian reserve.

We can also connect you with experienced doctors and clinics specializing in DOR and fertility treatments.

With Arva's support, you can explore all your options and make informed decisions about your family planning journey.

You’ve got this!