Normally, fertility is lost over time. In the female case there are several factors that can affect the ability to have a child. Among these factors is the low ovarian reservea question that affects approximately 10% of women, according to estimates. What is it, why does it happen and what solutions does it have?
What is the ovarian reserve?
This is the name given to a concept in Reproductive Medicine that covers the quantity of eggs that the woman has left and their quality. Contrary to what happens with male sperm, the number of oocytes available in the female body is finite.
These are found in the ovary, which is responsible for “maturating” a certain number each month. Of all of them, one will be the one that is available to be fertilized (under normal conditions).
This marks the fertile cycle of the woman, which also depends on the state of the eggs or, in other words, their quality. From the age of 35, the quality and number of available oocytes begin to decline.
In some cases, the ovarian reserve is called “low” due to a problem in its available quantity or its quality. We can also refer to these cases as “premature ovarian failure” or “early menopause”, although they are not always synonymous. In this situation, natural fertility, without a method that helps conception, may be unfeasible. It is then when it is convenient to put yourself in the hands of a specialist.
There is no single reason for low ovarian reserve.
Cases of low ovarian reserve They do not always have the same origin, since reproductive health depends on very diverse issues: from a genetic issue, to an autoimmune disease, through an infection or other environmental factors. In the worst case, we probably end up with infertility.
The low ovarian reserve manifests itself as a lack of response from the follicles, which are “the units” in charge of ovulation, because there are very few of them. Some patients with low ovarian reserve show a lower response to ovarian stimulation treatment, but produce very good quality eggs, which can help in the fertility process.
If there is a determining factor, that is the age. With age, as we said, both the quality and the quantity of oocytes decrease. However, each case is very particular and it is the specialist who must determine, based on a series of tests, what is the best way to deal with it in order to achieve a satisfactory pregnancy.
How do I know if I have low ovarian reserve?
The low ovarian reserve does not usually show any type of special symptoms, apart from the time spent unsuccessfully in conceiving. Yes, we can suspect that we are dealing with this case if there have been previous complications: ovarian cysts, autoimmune diseases or other similar problems.
Suspicion could also be given if we have a family history. In any case, the only way to ensure that we are facing a problem of low ovarian reserve is to perform a diagnostic test. The IVI Assisted Reproduction Clinics offer this type of test to measure the fertility of interested women.
With the aim of raising awareness of the importance of maternity planning, in our clinics we offer free AMH test to determine the status of the ovarian reserve. This AMH hormone, or antimüllerian hormone, is produced by the granulosa cells that accompany the follicle. Its concentration serves as an indication to assess the ovarian reserve each month.
At the IVI Clinics we also offer other tests to confirm and determine fertility and the situation of the ovarian reserve. For example, the basal hormonal study consists of a blood test that allows measuring the levels of FSH (follicle-stimulating hormone), LH (luteinizing hormone) and Estradiol. The AMH test has more predictive value than the hormonal study, but their combined results will allow the woman to know when she is fertile in order to make the decision she deems appropriate.
Pregnancy and low ovarian reserve: yes, it can
The most recent studies in this regard suggest that low ovarian reserve does not always mean a direct decrease in fertility. That’s how I checked a 2017 study whose results indicate that associating low ovarian reserve with infertility, in a clear way, is a mistake.
This means that even under this condition there could be a successful pregnancy. On the other hand, if there is a history of infertility, it is most likely that we will need specialized help. In such a case, pregnancy is also possible, as our experts say. have shown on numerous occasions.
For this, the IVI Reproductive Medicine Clinics They have specialized treatments, such as Ovarian Rejuvenation treatment or the low ovarian response treatment. At IVI, we are studying two rejuvenation techniques: OFFA, or ovarian fragmentation, and BMDSC, or infusion of bone marrow stem cells into the ovarian artery. Both aim to get the ovary becomes active again. At the moment, the results are being very positive and we have achieved several spontaneous pregnancies.
However, these procedures are still under investigation. But this is not a problem. At the IVI Clinics we advise and provide all the means and specialists necessary to ensure a woman’s pregnancy. For this we use the most advanced techniques in assisted reproduction, such as Artificial insemination wave In Vitro Fertilization (IVF)in addition to monitoring your fertility, which will allow you to take full advantage of the chances of pregnancy, or resort to to egg donation in case it is necessary.
