Low Egg Reserve: What You Need to Know

by | Female Infertility

Trying to conceive can be overwhelming. There are so many different factors at play that it’s honestly a miracle that any babies are conceived accidentally at all! When it’s just not happening for you and your partner, it’s understandable to start feeling frustrated and downtrodden. It’s important to see your doctor as soon as you start having concerns that conception may not happen easily for you. They’ll be able to run tests to see if there are any biological concerns delaying your ability to get pregnant.
One such concern is having a low ovarian reserve. Sometimes known as an egg reserve, this refers to the number and quality of eggs you have left. A low ovarian reserve means that you have less than the average number of eggs than is expected for your age, and can affect your ability to get pregnant in any given cycle. Here’s everything you need to know about having a low egg reserve.

How Do Doctors Test Your Egg Reserve?

It can be difficult to suspect a low ovarian reserve, simply because there aren’t many obvious symptoms. But some signs your doctor may ask you about include:
• Absent or late periods
• Shorter-than-average menstrual cycles
• Irregular periods, including heavy or light flow
• Miscarriage
These symptoms, combined with your age or lifestyle, may lead your doctor to suspect that you have low egg reserve. There are two ways to test ovarian reserve. They can perform a baseline pelvic sonogram during the first three days of your menstrual cycle. The sonogram will show the number of follicles in your ovaries that are available at the start of your cycle. A normal amount of follicles is a minimum of 12 per ovary and low is considered to be 1-10. If your sonogram shows a low number of follicles, your body may be trying to conserve them for the future, making it harder to conceive in any individual month.
Another way to test your ovarian reserve is with a blood test checking your Anti-Mullerian Hormone (AMH). AMH is produced by the future generations of follicles, not follicles of your current cycle, making it an ideal indicator of the ovarian reserve overall. AMH levels of 1.5 ng/ml or higher is considered normal and an AMH level of less than 1.0 ng/ml is considered low.

Treatment Options for Low Ovarian Reserve

If your doctor has determined that you have a diminished ovarian reserve, it’s important to remember that that doesn’t necessarily mean you can’t naturally conceive. After all, it only takes one egg to result in a successful pregnancy! Take a deep breath and focus on what your treatment options are to increase your chances of conception.
Medications can be used to stimulate the ovaries, but those medications generally only allow to the eggs that are already available to mature. You cannot generate more eggs than what nature provides. It’s painfully ironic that when your body thinks it’s helping you by only giving you a few eggs per cycle in order to delay menopause, it’s actually hurting your chances of getting pregnant.

For borderline or low ovarian reserve, IVF treatment can be an excellent option. There are IVF protocols that can help the maximum number of follicles reach maturity in your cycle. The estrogen primed antagonist protocol offered at IVFMD is one such IVF protocol that has helped many low reserve patients conceive over the years.

For very low ovarian reserve, IVF treatment may not be the best option. To increase the likelihood of getting pregnant, the Mini IVF protocol offered at IVFMD is recommended to patients with very low ovarian reserve. This gentler approach uses inexpensive medications such as clomiphene to release the natural stimulating hormones from the pituitary to make the available follicles grow. With Mini IVF, you save money by using lower doses of those stimulating medications. IVFMD has recently introduced using the INVOCELL capsule that allows a patient to carry her own embryos during the five-day culture period, which further decreases the overall cost.

For extremely low ovarian reserve, IVF treatment wouldn’t be the best or most cost-effective option. The risks involved with IVF aren’t worth the low success rate, especially if the patient is age 38 or older. Instead, ovulation induction with Intrauterine Insemination (IUI) for several cycles is the best option. IUI has a lower cost than IVF and avoids the heavy emotional burden that accompanies IVF treatments. A final option for patients with extremely low egg reserve is IVF with donor eggs.

What Can I Do to Improve My Odds?

Like most things in life, quality wins over quantity. While you might not have as many eggs in your reserve as you’d like, try to do everything in your power to give them the best environment in which to grow. Ways you can help out your eggs include:

  • Stop smoking. Women who smoke have a higher chance of experiencing early menopause. You should also avoid breathing in secondhand smoke, as the harmful chemicals in cigarette smoke have been shown to lead to a loss of eggs.
  • Maintain a healthy weight. Everything in your body works better when you maintain a healthy weight, including your ovaries. Ovaries also respond better to ovulation-induction medication when a patient has a healthy BMI of <35.
  • Keep your stress in check. Stress affects a number of things in the body, and that includes your ability to get pregnant. Stress decreases the release of natural stimulating hormones and can throw a wrench in Mini IVF treatments. Reduce your stress by relaxing, participating in light exercise, practicing meditation, and slowing your life down as much as possible.
  • Take natural antioxidants. Antioxidants neutralize free radicals, which can lead to cell damage. Antioxidants have been shown to increase the fertilization rate in patients undergoing IVF treatments. Blueberries, green tea, and many vegetables are great sources of antioxidants.
  • Take Coenzyme Q10 supplements. CoQ10 is an antioxidant found in most cells that mediates the chain reactions that make energy within the cell. CoQ10 is believed to help the cell division that occurs after fertilization, and can be taken in supplement form to encourage that cell division.
  • Consider taking DHEA- DHEA is an androgen precursor that can be converted to estrogen to help follicular growth. Taking 75 mg of DHEA a day for at least 3 months has been shown to increase the number of eggs collected.

Many women with low egg reserve have successfully conceived naturally over the years, both with and without medical help. So if you have been diagnosed with low ovarian reserve, don’t despair. Instead, be proactive and take charge to find the best way to reach success.To learn more about your options, feel free to contact us at IVFMD for a consultation.

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