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Are you over 35 and struggling to conceive? You should probably get a screening for an ovarian reserve. A lot of women these days are more careers oriented and delay their pregnancy beyond 30 years. However, a women’s biological age may not slow down as per their plan. A women’s ovary is packed with a definite number of eggs at the time of birth. This egg supply is referred to as an ovarian reserve. Maternal age is a strong determinant of the ovarian reserve. The supply of eggs peaks when the female is still in the fetus stage and will gradually decrease as the women ages until she reaches menopause. A female has about 7 million eggs at 20 weeks of gestation, approximately 2 million eggs at the time of birth and this declines steeply to about 25000 eggs at the age of 37. This means a woman is running on a countdown from the time of birth. Every menstrual cycle, an egg will be released by the ovary to facilitate fertilization and is lost if it does not encounter a sperm. Women with more egg supply will have better chances of conception. A poor or diminished ovarian reserve means that the quality and the quantity of the eggs have declined. This refers to the reproductive potential of women. It can decline due to factors other than age such as chemotherapy, ovarian surgery or genetic determinants. Not only the age of women is critical, but the age of the eggs is also important. This is important when donor eggs are being used as an alternative to conceive. Women below 35 years of age have better chances to conceive. A women’s fertility begins to decline when she hits 30 and it will be steeper above 35. Women also risk higher chances of miscarriages in their 40s. This results in infertility among women.

How do I know I have a diminished ovarian reserve if I?

A diminished ovarian reserve has no symptoms although there may be some abnormalities with the menstrual cycle such as heavy menstrual flow or irregular periods. A poor ovarian reserve can be indirectly checked by a blood test of the levels of female hormones such as Follicle-stimulating hormone (FSH) at day 3 of the menstrual cycle or Anti-Mullein hormone (AMH). A higher level of FSH or low levels of AMH will indicate diminished ovarian reserve. However, they are not definite factors. Increasing age will be the only direct indication of poor ovarian reserve.

Are there any treatments?

There are currently no clinical treatments. In such cases, egg donation may be the only feasible option for a successful pregnancy. Recent studies have unleashed the potential of stem cells in regenerating ovarian reserves. This can restore fertility in women who have crossed the fertile age. Since stem cells have the potential for stimulating formation of new eggs, women with a poor ovarian reserve can definitely be treated.  It can also be a new ray of hope for patients who have undergone radiation or chemotherapy treatments. Now age won’t be a barrier in deciding when you are trying to get pregnant.