Ovarian Reserve: A Comprehensive Guide

What is Ovarian Reserve?

Ovarian reserve plays a significant role in the fertility journey of people with female reproductive systems. It refers to the quantity and quality of eggs remaining in the ovaries. Understanding ovarian reserve is essential in order to assess your fertility potential when planning to conceive. In this comprehensive guide, we delve into the factors affecting ovarian reserve and the tests used to evaluate it.

Ovarian Reserve Tests

At IVI there are several tests we use to assess ovarian reserve. These tests include blood tests to measure hormone levels such as Anti-Mullerian Hormone (AMH), Follicle-Stimulating Hormone (FSH), and Oestradiol. Ultrasound scans can also be used to count the number of follicles in the ovaries, known as antral follicle count (AFC).

• Follicle-Stimulating Hormone (FSH) Test: This blood test measures the level of FSH, a hormone that stimulates the growth of follicles in the ovaries. Elevated FSH levels may indicate diminished ovarian reserve.
• Anti-Mullerian Hormone (AMH) Test: AMH is a hormone produced by the developing follicles in the ovaries. This blood test provides an estimate of the remaining egg supply.
• Antral Follicle Count (AFC) Test: This ultrasound-based test counts the number of small follicles in the ovaries. A higher AFC suggests a better ovarian reserve.
• Ovarian Ultrasound: A transvaginal ultrasound can provide visual information about the number and size of follicles in the ovaries.

What Factors Affect Ovarian Reserve?

• Age: The most significant factor influencing ovarian reserve is age. As women age, the quantity and quality of their eggs decline. Fertility typically starts to decline in the late 20s, with a more significant decrease after the age of 35.
• Genetics: Genetic factors can play a role in determining ovarian reserve. Some women may have a genetic predisposition to experience a faster decline in ovarian function.
• Previous Surgeries: Surgical procedures involving the ovaries, such as ovarian cyst removal or ovarian surgeries, can impact ovarian reserve. The extent of damage and the surgical technique used may affect the remaining ovarian tissue.
• Chemotherapy and Radiation Therapy: Cancer treatments, particularly chemotherapy and radiation therapy, can have damaging effects on the ovaries and may reduce ovarian reserve.
• Environmental Factors: Factors such as smoking, exposure to certain chemicals, and environmental pollutants may contribute to a decline in ovarian reserve.
• Medical Conditions: Certain medical conditions, such as endometriosis and polycystic ovary syndrome, can impact ovarian reserve. These conditions may affect the quantity and quality of the ovarian reserve.
• Ovarian Surgery: Any surgery involving the ovaries, such as ovarian cyst removal or removal of one or both ovaries, can affect ovarian reserve.
• Lifestyle Factors: Lifestyle choices, including diet, exercise, and stress levels, may influence ovarian reserve.

Relationship between menstrual cycle and ovarian reserve

The menstrual cycle and ovarian reserve are closely interconnected aspects of female reproductive health. The menstrual cycle is the regular, natural process that occurs in the female reproductive system, involving release of an egg and the preparation of the uterus for a potential pregnancy. Ovarian reserve, on the other hand, refers to the quantity and quality of a woman’s remaining eggs. Understanding the relationship between the menstrual cycle and ovarian reserve is essential in assessing a woman’s reproductive health. However, it’s important to note that while irregularities in the menstrual cycle may raise concerns about ovarian function, a comprehensive evaluation, including hormonal assessments and imaging studies, is often necessary to provide a more accurate assessment of ovarian reserve.

Implications of Ovarian Reserve:

• Fertility Potential: Understanding ovarian reserve can help women gauge their fertility potential and make informed decisions about family planning.
• Assisted Reproductive Technologies: Women with low ovarian reserve may require additional interventions, such as in IVF, to achieve pregnancy.
• Future Planning: Knowledge of ovarian reserve can guide women in considering options like egg freezing or fertility preservation.

How to improve ovarian reserve?

While it is not possible to increase the number of eggs a woman has, certain lifestyle changes can help to maintain the quality of eggs. Eating a balanced diet rich in antioxidants, maintaining a healthy weight, avoiding smoking and excessive alcohol consumption, and managing stress can all contribute to better ovarian health.

Best IVF protocol for low ovarian reserve

In cases of low ovarian reserve, IVF  can be a viable option for conceiving. The best IVF protocol for low ovarian reserve are dependent on the individual, some may involve a higher dosage of fertility medications to stimulate the ovaries and some quite the opposite.  At your initial consultation we’ll assess your ovarian reserve to determine the best direction for treatment. Depending on your individual circumstances, this could be an IVF treatment with your own eggs or in some cases an IVF treatment with donor eggs. 

Understanding ovarian reserve is crucial for those who are planning to start a family or want to assess their fertility potential. By considering the factors affecting ovarian reserve and undergoing appropriate tests, you can make informed decisions about your reproductive health. Age, lifestyle factors, and various tests can provide insights into ovarian reserve. While it is not possible to increase the number of eggs a woman has, maintaining a healthy lifestyle and seeking appropriate medical interventions can help optimize ovarian health. A consultation with our fertility specialists at IVI is recommended for personalised guidance and support. Remember, it’s never too early to start thinking about your ovarian health and taking steps to preserve it.