To assess your ovarian reserve, it is essential to consult a reproductive specialist. They will order a transvaginal ultrasound and hormonal tests to measure the quantity and quality of your eggs, and then create a personalized plan to help you achieve the dream of becoming a mother or father.
Below you will find clear information about what ovarian reserve is and how it affects your fertility.
What is ovarian reserve and what is it for?
Ovarian reserve is the number of eggs available in your ovaries throughout your reproductive life. We are born with between 1,000,000 and 2,000,000 follicles, which decrease to 300,000–500,000 by the time we reach puberty. Each month, dozens of follicles are recruited, but only one ovulates.
The best time in terms of egg quantity and quality is from ages 16 to 30, although it remains reasonably high between 31 and 34. After age 35, reserve declines more noticeably, and after 40 both quantity and quality decrease until menopause, which in Mexico usually occurs around age 48.
How does ovarian reserve influence your fertility?
Fertility is the ability to achieve pregnancy after 12 months of unprotected intercourse. According to the World Health Organization, more than 180 million people worldwide face infertility. One of the most common causes is low ovarian reserve, because it reduces the likelihood of finding a viable egg each cycle.
If you want to learn more about infertility factors and ovarian reserve, visit our article “Infertility Factors: Understanding the Ovarian Reserve.”
What factors reduce ovarian reserve besides age?
Besides age, other factors can affect your ovarian reserve:
- Smoking
- Genetic disorders
- Immunological problems
- Cancer treatments (radiation, chemotherapy)
- Endometriosis
For example, a 28-year-old woman with endometriosis may have the same reserve as a 40-year-old and face greater challenges conceiving.
Symptoms of low ovarian reserve
Some signs of low ovarian reserve include shorter or irregular cycles and low cervical mucus production. If it progresses to premature ovarian failure, menopause-like symptoms may appear:
- Amenorrhea (absence of menstruation)
- Hot flashes and night sweats
- Insomnia
- Vaginal dryness
- Decreased libido
- Pain during intercourse
- Irritability and frequent mood swings
- Thyroid problems
If you notice any of these symptoms, avoid self-medicating and see a Reproductive Medicine specialist to evaluate your reserve and learn the best options for you.
What can your menstrual cycles tell you about your ovarian reserve?
A normal menstrual cycle lasts 21 to 35 days, with bleeding for 2 to 7 days and a volume of 20–80 mL (2–5 sanitary pads per day). Changes in duration or quantity may indicate a hormonal imbalance affecting your ovarian reserve.
How is ovarian reserve measured?
The specialist usually performs:
- Medical history and physical examination.
- Follicle-stimulating hormone (FSH) and estradiol levels on day 3 of the cycle.
- Transvaginal ultrasound to count antral follicles. A normal count is 15–20 follicles; fewer than 6 indicates low reserve.
How to become a mother or father with low ovarian reserve?
If you are diagnosed with low reserve and want to have a baby, assisted reproduction techniques like in vitro fertilization with controlled ovarian stimulation are available.
After stimulation, eggs are retrieved under light anesthesia to obtain as many as possible. If your own eggs are not viable, egg donation may be considered.
Before making any decisions, always consult a Reproductive Medicine specialist to receive safe, personalized guidance.
For more details, visit What is low ovarian reserve?
Frequently asked questions about ovarian reserve
1. Does ovarian reserve determine my future fertility?
Ovarian reserve indicates how many eggs remain, not their quality. A higher follicle count increases the chances of a viable egg each cycle, although age affects genetic quality. Both variables are key.
A low count does not prevent pregnancy but may require assisted reproduction techniques to improve the odds.
2. Can I improve my ovarian reserve with lifestyle changes?
Quitting smoking, maintaining a healthy weight, and a balanced diet help preserve ovarian function. While they do not stop aging, they reduce external factors that accelerate reserve loss.
Managing chronic diseases and planning cancer treatments under medical supervision also has a positive impact.
3. How often should I evaluate my ovarian reserve?
There is no fixed schedule; annual evaluation is recommended if you plan a near-term pregnancy. Near age 35 or with risk factors, the specialist may suggest more frequent tests.
In fertility treatments, the medical team adjusts monitoring based on your response.
4. Do hormonal contraceptives affect my ovarian reserve?
Hormonal contraceptives do not permanently reduce reserve; they only inhibit ovulation while in use. After discontinuation, ovarian function and menstruation resume, although it may take weeks to stabilize.
If you plan a pregnancy, discuss with your gynecologist to determine the best time to stop them and evaluate your reserve.
Sources consulted
- ACOG. (2020). Practice Bulletin No. 234: Management of Anovulatory Bleeding. Obstetrics & Gynecology.
- Broekmans, F. J., et al. (2006). The antral follicle count: practical recommendations for better standardization. Human Reproduction, 21(3), 666–671.
- MedlinePlus. (2021). Infertility. https://medlineplus.gov/infertility.html
- WHO. (2019). Infertility. https://www.who.int/health-topics/infertility#tab=tab_1
We send you all our support on this journey. Remember that every case is unique: always consult an assisted reproduction specialist for the best guidance.