Low ovarian reserve is a condition that impacts a woman’s fertility, characterized by a reduced number and lower quality of eggs in the ovaries. Although it usually appears after age 35, genetic, environmental factors and certain diseases can accelerate this process in younger women.
What is low ovarian reserve and how does it affect fertility?
Ovarian reserve measures how many viable eggs (oocytes) you have. We are born with a limited number and, over time, both quantity and quality decline. When the antral follicles detected by ultrasound are few and the antimüllerian hormone (AMH) in blood is low, the chances of conceiving naturally decrease and assisted reproduction may be necessary.
Why is ovarian reserve important for conception?
Knowing your ovarian reserve helps you plan your path to motherhood or fatherhood more effectively. A healthy reserve generally responds well to stimulation treatments, producing more mature eggs for fertilization, whether naturally or via in vitro fertilization, and improves successful pregnancy rates.
What causes low ovarian reserve?
Some factors can accelerate egg loss:
- Advanced age: After 35, egg quality and quantity decline more rapidly.
- Genetic factors: FMR1 gene premutations or premature ovarian insufficiency reduce reserve.
- Medical treatments: Chemotherapy or pelvic radiation can damage the ovaries.
- Ovarian surgery: Removing cysts or endometriomas removes healthy follicles.
- Autoimmune diseases: Lupus or thyroid disorders affect ovarian function.
How is low ovarian reserve diagnosed?
The following are used to confirm this diagnosis:
- Hormonal tests: FSH >10 IU/L on day 3 of the cycle or AMH <1 ng/mL indicate low reserve.
- Transvaginal ultrasound: Antral follicle count (AFC) of 5–7 in both ovaries suggests low reserve.
What are the treatment options?
Despite the challenge, there are several paths to pursue pregnancy:
- In Vitro Fertilization (IVF): Tailored protocols retrieve all available mature eggs. More info at Infertility Factors: Understanding Ovarian Reserve.
- Egg donation: Using donor eggs can increase success rates.
- Supplements and lifestyle: Antioxidants (CoQ10 200 mg/day), a BMI between 18.5–24.9 kg/m² and avoiding smoking help maintain egg health.
How to cope emotionally with this process?
Fertility is also an emotional journey. Seeking support through therapy, specialized groups or loved ones makes a difference. Sharing experiences relieves stress and helps you feel supported. “Avoid self-medication: always consult a reproductive specialist before any treatment.”
Frequently Asked Questions (FAQ)
1. Can diet improve ovarian reserve?
A diet rich in fruits, vegetables and healthy fats (omega-3) reduces oxidative stress and supports egg quality, but does not increase follicle count. Combine it with medical monitoring and supplements (folic acid, CoQ10) under supervision.
2. At what age should I assess my ovarian reserve?
If you plan to conceive in the future, get a check-up starting at age 30. After 35, it’s urgent, especially if you have irregular cycles or a family history of early menopause. Early diagnosis allows options like egg freezing or timing adjustments.
3. What does a low AMH level mean?
AMH reflects the number of resting follicles. A level <1 ng/mL indicates few ovarian options and a limited response to stimulation, but does not predict egg quality. Along with FSH and AFC, it gives your doctor a complete picture.
4. Is natural pregnancy possible with low ovarian reserve?
Yes, although the chances are lower, especially with other factors. A healthy lifestyle and cycle monitoring help identify the best time to try. Many opt for assisted reproduction after medical advice.
Sources Consulted
- American Society for Reproductive Medicine. (2015). Practice Committee Opinion: Testing and interpreting measures of ovarian reserve. Fertility and Sterility, 103(3), e9–e17.
- Broer, S. L., Broekmans, F. J. M., & Fauser, B. C. J. M. (2014). Anti-Müllerian hormone: ovarian reserve testing and its potential clinical implications. Human Reproduction Update, 20(5), 688–701.
- MedlinePlus. (2022). Anti-Müllerian Hormone (AMH). U.S. National Library of Medicine.
- National Institute for Health and Care Excellence. (2013). Fertility problems: assessment and treatment (CG156).
Remember you are not alone on this journey. Every story is unique and deserves a personalized plan. If you suspect low ovarian reserve or have questions, consult a fertility specialist who will guide you with professionalism and empathy.