Understanding everything about the diminished ovarian reserve: A leading cause of female infertility
Published in: Zee The Health Site
9thApril 2021
Diminished ovarian reserve is a common cause of female infertility that affects about 10 per cent of women in India. Here’s everything you need to know about the condition.
Diminished ovarian reserve is a common cause of female infertility in India. It affects women of any age, and around ten per cent of women in India have this condition. To get a successful pregnancy, several women with diminished ovarian reserve consult their IVF doctor. It is among the best treatments available to become pregnant with diminished ovarian reserve. Before talking about more diminished ovarian reserve, let us understand what it means.
What Is Diminished Ovarian Reserve?
The term “ovarian reserve” means your egg’s quality and number, also known as oocytes. It means that your egg’s number and quality are fewer than expected as per your age. Hence, let us learn what the average egg count is as per your age.
What Is The Average Egg Count By Age?
The “average” egg’s number inside your ovarian reserve is dependent on age. You are born having all the eggs that will be there in your lifetime. The egg reserve begins decreasing as you age.
According to research, here are the average egg’s numbers you have at every age:
- Twenty weeks of gestation: about 6 to 7 million oocytes
- After Birth: about 1 to 2 million oocytes
- During Puberty: about 300,000 to 500,000 oocytes
- About age 37: approximately 25,000 oocytes
- At age 51: During menopause, about 1,000 oocytes
Women with diminished ovarian reserve have fewer eggs than other women. Furthermore, it is not clear how many average eggs a woman with diminished ovarian reserve has. According to research, hormone levels usually define diminished ovarian reserve and not the egg’s amount inside the ovarian reserve, confusing the condition’s definition. Now that you have learned about the egg’s number in a normal woman, let us understand what causes diminished ovarian reserve.
Causes of Diminished Ovarian Reserve
Ageing generally reduces your egg reserves. Yet, few other factors can lead to the health condition. They are:
- Prior ovarian surgery radiation therapy
- Smoking
- Pelvic infection tubal disease
- Endometriosis
- Autoimmune disorders
- Chemotherapy
- Genetic abnormalities like fragile x syndrome
- Thyroid antibodies
- Tuberculosis
- Family history of early menopause
- Yet, many times there is no known cause of the condition.
Symptoms
There are no noticeable symptoms of the condition. Yet, individuals having the condition may experience any of the below signs:
- Problems becoming pregnant
- Late or absent menstrual periods
- Fewer menstrual cycles than average and the average is twenty-eight days
- Heavy menstrual flow
- Miscarriage
However, these signs are not always present. This is why you should consult your fertility doctor if you are having issues conceiving.
Diagnosis
According to research, it is better to do fertility testing initially if:
- You are trying to conceive; still, there was no success
- You have a painful or irregular periods’ history
- Pelvic inflammatory conditions
- Repeating miscarriages
- Prior cancer treatment
- Endometriosis
Initial diagnosis has a good chance of successful treatment for you. If you are under thirty-five years of age, you should go to a doctor if you have been trying to get pregnant for a year.
Treatment
It is possible that you can conceive with a diminished ovarian reserve. According to a study, thirty-three per cent of women with this condition conceived with their eggs after treatment. However, the study suggests that initial diagnosis is significant, as it has a good chance of conceiving.
Among the most performed diminished ovarian reserves treatments are supplements such as dehydroepiandrosterone (DHEA), a mild androgen. DHEA is made inside your body, yet the level of DHEA lessens with age. So, taking DHEA supplements can improve fertility.
Instead of DHEA supplements, there are few ways to conceive if you have the condition. If diminished ovarian reserve gets diagnosed soon, your healthy eggs can be frozen for future utilization. Your specialist may even suggest trying IVF immediately.
Another option to conceive is with donor eggs. Eggs will be acquired from a donor. The eggs will get fertilized with IVF and implanted inside your uterus. The treatment you do is based on your condition, so it is essential to discuss all the options with a fertility expert.
The Takeaway
You might get discouraged after knowing that you have a diminished ovarian reserve. However, you can conceive with your eggs or donor eggs while having the condition. If you think you have the condition or have issues with conceiving, visit your fertility doctor.
(Authored by Dr Hrishikesh Pai, Consultant Gynaecologist and Infertility specialist, Lilavati Hospital, Mumbai, D Y Patil Hospital, Navi Mumbai and Fortis Hospitals, New Delhi, Gurugram and Chandigarh)