Low Ovarian Reserve

Low ovarian reserve is a condition that indicates a decreased number and quality of eggs in a woman’s ovaries. Every woman is born with a fixed number of eggs, and as she ages, this number gradually declines. The decline becomes more pronounced after the age of 35, leading to concerns about fertility. Factors such as surgeries like ovarian cystectomy or ovariotomy can also contribute to a significant reduction in ovarian reserve.

How is Ovarian Reserve Assessed?

Ovarian reserve is primarily assessed through two gold-standard tests:

Anti-Müllerian Hormone (AMH) Test: AMH is a hormone produced by the small follicles in the ovaries. A blood test measures its levels, which indicate the quantity of available eggs. AMH levels remain constant throughout the menstrual cycle, making it easy to test at any time. A value below 1.5 ng/ml is considered low normal, while values below 1 ng/ml indicate low ovarian reserve.
Antral Follicle Count (AFC): An AFC is determined via a transvaginal ultrasound performed between days 2 to 5 of the menstrual cycle. This count reflects the number of small follicles present in the ovaries and provides insights into the egg supply. An AFC of more than 10, considering both ovaries, is typically seen as favorable.

Importance of Ovarian Reserve

Understanding ovarian reserve is crucial for assessing a woman’s fertility potential. While it does not guarantee pregnancy, a lower ovarian reserve can indicate a shorter fertility window. In assisted reproductive techniques like IVF, ovarian reserve significantly impacts the number of viable eggs available, which directly influences the chances of successful conception.

Can AMH Levels Be Improved?

Since AMH levels reflect ovarian aging, increasing these values is challenging due to the natural aging process. However, certain lifestyle changes and supplements may help improve egg quality, though they cannot reverse the decline in ovarian reserve.

Do Low AMH Levels Necessitate IVF?

Low AMH levels can be an indication for IVF, but whether IVF is the right choice depends on individual circumstances. A comprehensive consultation with a fertility specialist like Dr. Sandeep Talwar is essential to determine the best course of action for couples facing fertility challenges.