What is Low Ovarian Reserve?

A woman’s ovarian reserve is the medical term for how many eggs a woman has left.  As a woman’s ovarian reserve depletes (which happens naturally as women age), the likelihood of her getting pregnant also decreases. 

Technically, when a female is still in the womb, she will have developed approximately six to seven million eggs. But over time, the egg count decreases. By puberty, females typically have 250,000 to 500,000 eggs. By the time women reach 37 years young, they will only have 37,000 and by menopause, less than 1,000.

While aging is the most common cause of low ovarian reserve, there are other reasons someone who is young could suffer from this, such as chromosomal abnormalities, like Turner Syndrome, or gene abnormalities, like Fragile X. Low ovarian reserve can also be caused by ovarian tissue damage through torsion, surgical removal of part of the ovary, ovarian cysts caused by endometriosis, benign or malignant ovarian tumors, radiation or chemotherapy, immunological conditions, pelvic adhesions or a high body mass index.

As always, the IVF success rate for all age groups with low ovarian reserve truly depends on how many viable eggs one of IVF Michigan’s doctors can obtain. If a fertility specialist can only obtain four or fewer eggs from a patient, the odds of not getting pregnant triples.

One of the earliest clinical signs of low ovarian reserve is shortening of the menstrual cycle. Family history of early menopause can increase the likelihood of having low ovarian reserve.  

Testing the ovarian reserve is simple. It requires a blood test to assess the levels of ovarian hormones, mainly the Anti-Mullerian hormone (AMH) and Follicle stimulating Hormone (FSH). AMH level is becoming the most accepted test because it does not fluctuate during the menstrual cycle and can better predict the number of eggs retrieved during IVF.  Women with low egg reserve should have a complete work up to try to understand if there is any underlying cause.

Dr. Hammoud, a fertility specialist at IVF Michigan, who has a special interest in this topic, suggests that testing and treating vitamin D deficiency could improve ovarian reserve for some women. In addition, when undergoing IVF, new stimulation protocols such as estrogen or testosterone priming with embryo banking can be effective.

If you have low ovarian reserve, IVF Michigan recommends sitting down with one of our doctors to discuss your options. Unfortunately, some women with low ovarian reserve may not be strong candidates for in vitro fertilization using their own eggs; however, donor eggs are another option IVF Michigan can provide.