Maternal age is the key parameter of female fertility. As a woman grows older, her fertility declines steadily. It is attributed to the number and quality of eggs which deteriorates with every passing year. Age-related female infertility issues are a universal phenomenon, though even much younger women can experience difficulty in conceiving. It is important to understand the connection between age and egg quality to answer the big fertility question.
Nature bestows a female with millions of eggs at the time of her birth. The number of these eggs decreases during her lifespan, ending as her menopause sets in. Surprisingly, only one percent of the total number of eggs is ovulated during the reproductive lifespan of a woman. It is not only the number of eggs that is important but their quality too. Poor quality eggs translate into lower pregnancy rate, higher risk of genetic abnormalities and higher rate of pregnancy loss. Therefore, understanding the ovarian reserve is of great significance to resolve related infertility issues.
Ovarian Reserve: Studying your Ovaries and Eggs
Ovarian reserve refers to the ability of the ovaries to produce eggs. It has a direct influence on her ability to have babies. This is the reason why infertility specialists evaluate the patient’s ovarian reserve right at the beginning of the infertility treatment. It can be well understood that ovarian reserve is dependent on a woman’s age. However, there are other factors that influence it. These include poor lifestyle, genetic conditions, smoking and cancer treatment.
As a woman grows older, the ovaries lose their capacity to produce healthy eggs. It is not only the ovaries that lose their functionality but the genetic makeup of the oocytes changes too. The cell division process in older oocytes is altered. Consequently, the eggs of the older women become genetically abnormal and their quality decreases drastically. This lowers the odds of conception at advanced maternal age. In case the woman does get pregnant, she might go through miscarriage or have an abnormal baby.
A comprehensive study of the ovarian reserve can give a fair idea about a woman’s reproductive capacity. It helps the specialist to learn how much time she is left with, if she plans a pregnancy in near future. Also, it enables them to chalk out a strategy for treating age-related infertility in a timely and effective manner. The specialist can decide the infertility treatment(IUI, IVF or egg donation) that would be best suited for the patient.
Ovarian Reserve Testing: Gauging Female Fertility
Whether a woman is struggling with infertility or she wants to opt for a planned motherhood, she needs to take ovarian reserve tests for gauging her fertility. There are three main tests which are used to assess the capability of ovaries to produce healthy eggs:
AMH Test: AMH Test measures the levels of anti-Mullerian hormone, a hormone synthesized by the follicles during the earliest developmental stage. It is an accurate measure of female fertility as it gives an idea about the number of oocytes that her ovaries will produce. Low AMH level (less than 1) indicates poor fertility, with lesser number of healthy oocytes available for conception. Conversely, an AMH of around 3.5 is an indication that a woman is healthy enough to get pregnant without assistance.
Day 3 FSH Test: FSH or Follicle Stimulating Hormone is another hormone which plays a key role in reproductive process. It stimulates the production of eggs in the woman’s ovaries. Day 3 FSH test measures the level of the hormone on the third day of the menstrual cycle. The level of this hormone increases with maternal age and abnormally high FSH levels indicate infertility issues. Even if the woman does conceive, the chances of a miscarriage are high. Clomiphene Citrate Challenge Test (CCCT) is an advanced version of FSH Test. It studies the levels of FSH while the woman is administered Clomid therapy for ovarian induction.
Antral Follicle Count: Another test used to measure the ovarian reserve is Antral Follicle Count. It is an ultrasound examination which evaluates the number of antral (immature) follicles in the ovaries. A lower number indicates lower chances of conception and poor response to therapy. A number too high points out the risk of ovarian hyperstimulation if the woman is subjected to hormonal stimulation.
All these tests are better equipped to predict the number of eggs that are available for reproduction. For determining the egg quality, age is considered as the more reliable parameter. Both can be seen in combination to get an estimate about a woman’s reproductive capacity, based on her egg count and quality.
A thorough study of ovarian reserve can be useful for the patient as well as the infertility specialists. The patient can use the result to plan her future, particularly if she wishes to delay motherhood. She can even take pre-emptive measures such as egg freezing to preserve her fertility for the future. The specialist can plan an infertility treatment strategy based on the reserves the patient’s ovaries have with them.
Gaudium IVF is one of the leading IVF clinics in India. It is a trusted name when it comes to providing quality treatment with high success rates in even the most complicated cases. Visit today for a free second opinion from Dr Manika Khanna, the renowned infertility specialist in Delhi.