Diminished ovarian reserve: Everything you need to know

For most couples, the joy of achieving pregnancy is a very easy road. Some need additional help, time, and resources to achieve the same joyous result. For the latter group, medical tests and diagnosis are key. There are so many advanced tests available for both men and women, some of which can gauge the status of your ovaries. If tests give a report that you have a diminished ovarian reserve, it might be confusing to you, and your first thought would be how it will affect your chances of conceiving. 

What are ovarian reserve and diminished ovarian reserve?

A woman’s ovarian reserve measures up to the number and quality of the female’s eggs at any given time. All women are born with a finite set number of eggs in the ovaries, which is your ovarian reserve. So a “diminished ovarian reserve means that your eggs are lower in number or quality than expected for your age.” 

Diminished ovarian reserve is not the same as premature ovarian failure. Premature ovarian failure is a condition where the ovaries lose their normal function before they turn 40. In diminished ovarian reserve:

  • The ovaries do not produce the required amounts of the estrogen hormone 
  • Release eggs regularly, making it tough to get pregnant without reproductive assistance.

The prime reproductive years, where the ovaries function at their best, are between the late teens and late 20s. After this window, it’s natural for both the quantity and quality of eggs to go down. Due to this natural decrease, your ability to get pregnant will start to decrease steadily after age 30, declining more by the time you reach your mid-30s. The decline is steady but not a cliff that suddenly changes your chances of conceiving drastically at any one point. By the time women reach 45, it’s unlikely that they will get pregnant without some form of medical intervention like IVF.

Reasons for diminished ovarian reserve

We have understood that having a diminished ovarian reserve means for a woman who is in her 30s, the quality and quantity of the eggs are like someone who’s 45. The most common factors for this are:

  • Chemotherapy
  • Radiation
  • Ovarian surgery for an ovarian cyst or ovarian cancer
  • Mutations in genes that are related to ovarian function
  • Endometriomas
  • Ovarian Cysts
  • Pelvic inflammatory disease due to untreated sexually transmitted diseases.
  • Infection of the reproductive organs 
  • Unexplained reasons

Diagnosing the diminished ovarian reserve

There are few prerequisites to even consider a test. The ZIVA fertility experts will consider factors such as age, period of trying, medical history, and lifestyle before recommending testing. 

Transvaginal ultrasound: To find out the ovarian reserve, a transvaginal ultrasound is done. In the ultrasound, the doctor or an ultrasound technician will insert an ultrasound probe into your vagina to get a better look at your ovaries and other reproductive organs. It is not as physically uncomfortable as it might sound. 

After the transvaginal ultrasound, the doctor will examine your ovarian antral follicle count, which tells them how many follicles you have on each ovary. 

Blood tests: Blood tests are also done to look into your ovarian reserve. One of the blood tests will check the level of follicle-stimulating hormone (FSH) in your blood. When your periods are to begin, the pituitary gland in your brain produces this hormone to make your ovaries create those egg-containing follicles for ovulation. The ovarian reserve test is done by day four of your menstrual cycle. 

The second blood test will check for anti-Müllerian hormone (AMH), a protein made by the cells that surround each egg. The test can be done at any time during your period. AMH levels vary for different age groups, and similar to the number of eggs, this protein will also reduce with age. So, this protein test is very helpful, along with the other tests.

Following the test results, you have to meet with a fertility specialist who can suggest the next steps depending on the severity of your situation. Ovulation stimulation medication is started. 

Diminished ovarian reserve and pregnancy

If you have a diminished ovarian reserve, it does not mean that you’re destined for infertility as you get older or that you can’t get pregnant. The amount of time you should wait to see a doctor when trying to conceive rests largely on your age.

  • With diminished ovarian reserve, if your age is below 35, please try for at least a year to get pregnant. 
  • For women between the ages of 35 and 40, try for 6 months before deciding to consult a ZIVA fertility expert.
  • For those above the age of 40, start your pregnancy journey by consulting our ZIVA Fertility expert. 

Please reveal your history of certain health issues, like irregular or painful periods, repeated miscarriages, or endometriosis.

IUI: In order to get pregnant, intrauterine insemination (IUI) is recommended, where the sperm is placed inside your uterus. This drastically increases the odds that you’ll get pregnant in a particular cycle.

IVF: If the ovarian reserve is low enough that IUI won’t work to achieve pregnancy, then your doctor might suggest in vitro fertilization. In an IVF, the eggs and sperm are fertilized in a lab. The resultant healthy embryos are implanted in your uterus.

Donor eggs: In some cases, donor eggs can also be used. Since the uterus, fortunately, does not age, the donor eggs can be fertilized with the partner’s sperm. The healthy embryos can be placed in the woman’s uterus, which has a very high chance of a successful pregnancy.

The bottom line about “Diminished ovarian reserve: Everything you need to know.”

Nowadays, people are very aware of their reproductive health. However, unexplained reasons and some medical history might contribute to diminished ovarian reserve. But still, there are many ways to achieve pregnancy. So, we at ZIVA Fertility Clinics advise you to keep an open mind and explore your options with our fertility expert. For more information, please get in touch with +91-9100002737, +91-9392834024, info@zivafertility.com or visit our website https://zivafertility.com/