How Ovarian Reserve Affects Fertility

How Ovarian Reserve Affects Fertility

While trying to conceive, most infertile women are faced with the puzzling subject of ovarian reserves right at the start. While it is not always crystal clear what role ovarian reserve plays in fertility, it can be even more confusing to understand what low and high levels mean to the prospect of a woman’s fertility and conceiving. Claim Your 20 Free Pregnancy Tests – Click Here

Therefore we will take a look at the key role ovarian reserve plays in conception, and enumerate the various problems in relation to a woman’s egg pool. Finally, we shall take a look at the possible solutions that can help achieve pregnancy even if the number of eggs or their quality in the ovarian reserve is low.

What exactly is ovarian reserve?

The ovarian reserve or the pool of eggs is exactly that; it can be understood as a storage where all the potential embryo candidates are stored in a premature state. The state of this supply of eggs is a prominent indicator of a woman’s fertility. Now let us take a look at exactly why that is. A woman is born with a set number of healthy eggs, that are gradually consumed starting with the first menstruation.

With age, a woman’s supply of eggs declines, and when a woman’s ovarian reserve is entirely depleted, menopause occurs. As you can see, a woman’s reproductive life lasts from the first menstruation until menopause; as long as there are eggs for conception in the ovarian reserve.

Effects of age on ovarian reserve

However, while the ovarian reserve is a prerequisite to successful conception, the quality of eggs also has a tremendous influence in achieving pregnancy. At the beginning of the menstrual cycle the ovarian reserve is showered in FSH, a special hormone that triggers the eggs’ maturation.

However, the most healthy, most sensitive eggs react first and immediately start their journey into the fallopian tube. Some eggs, on the other hand simply die. This means that the older the woman is, the more FSH is required to jump start the maturation of the eggs.

Chances of conceiving

Your chances of conceiving depend largely on a number of factors such as age, the number of eggs in reserve, the quality and so forth. First of all the number of eggs available for conception to a woman is in direct relation to the woman’s age. Furthermore, the most healthy, sensitive eggs are picked first for maturation during monthly cycles.

This means that the weaker, less sensitive eggs are left behind for later use. So the quality of available eggs, those that were left behind during previous cycles, also declines with age. As we can see, the ovarian reserve and age play a significant role in fertility.

Day 3 FSH levels test

As we have seen, there is one foolproof indicator of low egg quality: the amount of FSH required to jumpstart egg maturation. So one test method is to measure the presence of FSH in your system on the third day of the menstrual cycle. In this case results above 10 indicate elevated FSH levels, which means the quality of eggs is not perfect, while a result of 20 indicates an almost 0 chance of conception using the woman’s own eggs.

Anti-mullerian hormone test

There is another method, called the anti-mullerian hormone test, which is a blood test that is not restricted to the third day of the cycle, it can be done on any day. As the name of the test indicates, this method measures the presence of AMH in your system.

Since the more FSH is present in your system, the less AMH is going to be detectable, the higher the AMH test results, the better. But to give you a quick reference: the results are normal between 0.7 and 5.0, but an ideal result is above 1.2.

Ovarian assessment report

There is also a third method, called the ovarian assessment report, which consists of a pelvic ultrasound exam on the third day of the cycle, and produces an egg retrieval score. The score can be anywhere between 1 and 20. We can interpret the results in the following way: 16-20 is excellent, 11-15 is good, 6-10 is fair, and less than 6 is reduced.

Diminished ovarian reserve

There are several solutions a woman can choose in case of diminished ovarian reserve, such as egg donation programs, which has been successful even in case of 50 year old women, or egg freezing solutions can also be helpful.

While there are solutions available to us today, we have to be careful when we postpone pregnancy in favour of other ambitions, oblivious to the fact, that our body does not wait; it will cross the point of no return. Women trying to conceive for years without success know all too well that a child is a blessing above all else.

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Monica Scott, BS, RN
Monica Scott, BS, RN | ConceiveEasy
Ms. Scott joined ConceiveEasy after working in prenatal obstetrical care for two years in a private practice before being promoted to Director of Nursing. She has a strong interest in women's health with an emphasis on promoting fertility awareness.