Women are born with a limited ovarian supply, meaning a set number of eggs. Ovarian reserve refers to the number of eggs we have in our ovaries at a given point in our lives, impacting the likelihood of achieving pregnancy, whether naturally or through assisted reproductive techniques.

Our ability to conceive a child naturally decreases as we age because fewer eggs are available, and their quality also diminishes. This, combined with the increased risk of chromosomal abnormalities (genetic material) in the eggs, can increase the chance of miscarriage. Together, these factors contribute to lower pregnancy rates and higher rates of spontaneous miscarriage in women who decide to become mothers at a later age.

Although the likelihood of pregnancy decreases over time due to a reduction in ovarian reserve, the exact age this happens varies from woman to woman. Some studies suggest that the decline in oocyte reserve (eggs) accelerates progressively after age 37. However, for some women, this decline occurs earlier than typically expected. In fact, it’s estimated that around one-third of couples will face difficulties conceiving if the woman is 35 or older, as this age marks a significant drop in ovarian reserve and egg quality.

As we can see, our ovarian supply is genetically determined. Oocytes form during fetal development, and the ones we have are produced before birth. By the fifth month of pregnancy, a female fetus’s ovaries contain an average of seven million oocytes, but at birth, a large portion is lost, leaving between one and two million. This number continues to decline as we age. In today’s modern world, women increasingly postpone motherhood, often choosing to become pregnant after the ages of 35-37, once we’ve achieved our goals in other areas like education and career. However, at this age, ovarian reserve sharply declines. Despite living a healthy lifestyle, the biological clock keeps ticking, and we cannot halt or fight the effects it has.

Age significantly affects our ovarian reserve and the quality of oocytes, which impacts our chances of pregnancy. Surgeries on the ovaries and conditions like endometriosis, which causes ovarian cysts, also reduce ovarian reserve. Another condition, Premature Ovarian Insufficiency (POI), also known as premature ovarian failure, has a genetic origin and causes the depletion of eggs before age 40.

So, if you plan to become pregnant, it’s important to know your ovarian reserve, whether it’s normal or low, and consider both your chronological age and the biological age of your ovaries so you can make timely decisions. There are tests that can easily and accurately determine your ovarian reserve, such as a transvaginal pelvic ultrasound to count antral follicles, along with hormone level measurements.

How can we determine if we have a normal ovarian reserve? By visiting a specialist in assisted reproduction who can perform an ultrasound assessment and the AFC (antral follicle count), along with measuring Anti-Müllerian Hormone (AMH), a specific hormone for evaluating ovarian reserve, measured through a blood test.

If you have a low ovarian reserve, it will be more challenging to achieve pregnancy. Fortunately, fertility preservation treatments exist, or multiple ovarian stimulations can be done to collect enough eggs to increase the chances of success in in vitro fertilization. Ovarian stimulation involves administering hormonal medications (ovulation medications) that hyperstimulate the ovaries to produce multiple eggs. This is sometimes referred to as enhanced follicle recruitment or controlled ovarian stimulation.

Resolve all your questions with Profamilia Fertility. Remember to consult as soon as possible so we can provide you with the most suitable treatment.

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