Decreased Ovarian Reserve - What does it mean?

Sep 15, 2024By shradhaivf IVF & Maternity
shradhaivf IVF & Maternity

Reduced ovarian reserve is a term used to describe a situation where a person has fewer eggs left in their ovaries compared to others in their age group. This condition can hinder the fertility rate. Fertility treatment is a feasible option for those dealing with diminished ovarian reserve.

What is low ovarian reserve, and how does it affect fertility?

Diminished ovarian reserve is a genetic condition that signifies a lower number of eggs in the ovaries compared to others of the same age. This condition is also referred to as low egg count or low ovarian reserve. 
Having a diminished ovarian reserve doesn't mean that you don’t have a chance of pregnancy. It simply means that you might face difficulties in getting pregnant and that you may need to consider fertility treatment like IVF.

How many eggs does a woman have?

At the time of birth, a female has all the eggs in her ovary, which she will release throughout life. . It gradually decreases with age, and the rate of decrease is accelerated after 35 years.

Some average parameters are as below:

• At birth, she has 1 to 2 million eggs.

• At puberty, the count decreases to 300,000 to 400,000 eggs, but only 400 will mature and ovulate. 

• At age 40, the egg in the ovary demises to a mere 25,000 eggs.

• At menopause, the count is almost depleted to less than 1,000 eggs.


Can you get pregnant with a low ovarian reserve?

It takes only one egg to get pregnant.

Rest assured that it is possible to get pregnant even with low ovarian reserve. Despite the fact that our chances of conception might be lower due to a diminished ovarian reserve, remember that it only takes one egg to get pregnant. 
The number of eggs is not the only factor that determines the possibility of pregnancy. The quality of the egg, the sperm's fertility, and the overall health of the uterus and fallopian tubes also play a crucial role in conception.

What are the signs of a low ovarian reserve?

Usually, the only symptom individuals might notice is difficulty in conceiving after several months or even years of regular sexual activity. There may be shortening in the menstrual cycle.

In case of primary ovarian insufficiency, you might also experience symptoms of perimenopause, such as:

• Hot flushes.

• irregular periods.

• Dryness of the vagina.


What influences a decrease in ovarian reserve?

Aging is a major factor that leads to a decrease in ovarian reserve, but there may be some other causes. Some genetic factors or medical treatments can cause a decrease in ovarian reserve. 
These include:

High consumption of Cigarette & smoking

• Diseases related to the X chromosome.

• Cancer therapies, such as radiation or chemotherapy.

• Undergoing an oophorectomy.

• Ovarian atrophy, or the wasting away of one or both ovaries.

• Autoimmune diseases.


Does stress lead to a decrease in ovarian reserve?

In fact, stress does not cause a decrease in ovarian reserve. Only smoking and tobacco use are the only lifestyle factors that has have scientific evidence and have been associated with a decrease in ovarian reserve.

Are there any tests to detect diminished ovarian reserve?

Having low ovarian reserve does not necessarily mean infertility. These tests do not reflect your natural fertility.

Tests to detect ovarian reserve include:

• Blood tests, which measure levels of anti-mullerian hormone (AMH), which is low, or follicle-stimulating hormone (FSH), which is high, and estradiol. These tests evaluate your potential response to ovarian stimulation or fertility treatment.

Vaginal ultrasonography is a diagnostic method used to measure ovarian volume and count the number of follicles present. This is known as antral follicle count (AFC).


Can diminished ovarian reserve be treated?

Till date, science does not have any definite way to reverse diminished ovarian reserve or boost egg production. 
Potential treatment options include freezing of ovarian eggs for future use, attempts at natural conception, or in vitro fertilisation (IVF) using either your own eggs or donated ones.

Can we preserve our eggs for the future?

If you are diagnosed with low ovarian reserve, it is important to act fast, undergo fertility treatment, & get as many eggs cryopreserved to avoid a potential decline in egg quality & number.

Egg cryopreservation involves the use of hormones to stimulate the ovaries for optimal egg production. Subsequently, the mature eggs are collected and stored for future in vitro fertilisation procedures.

You may also opt for IVF & get your embryos preserved; this process involves fertilising the mature eggs with sperm from your partner or a donor, then freezing them for future use or implanting them into your uterus for conception in the near future. Freezing your embryo does not guarantee future pregnancy, as the last point of hurdle, i.e., successful embryo implantation, is the determining step. With age, the rate of successful implantation also decreases.

What is the concept behind Donor Egg?

In case your ovarian reserve is nil or the quality of the egg is not good, legal provision for egg donation is there. The advantage is that your male partner's sperm is used to fertilise with a donor egg, & so the child will have the gene of your husband. The embryo so formed will be implanted in your uterus at an appropriate time, & after successful implantation, the child will be born in your womb.


The counterpart scenario may be that if your partner's sperm is nil or of poor quality, then donor sperm may be used in a legal manner, from which embryos can be formed & cryopreserved for the future.

Is there any way to decrease the chance of diminished ovarian reserve?

There is no scientific way to prevent the development of low ovarian reserve, but a healthy lifestyle like exercise, avoiding cigarettes, and eating healthy food will help in maintaining the quality of eggs. Even few healthy eggs may

How does IVF treatment help in women with low ovarian reserve?

Women with low ovarian reserve and who are not conceiving definitely have a very low chance to naturally get pregnant. IVF is hence the mainstay of treatment, despite the fact that success of IVF also decreases in patients with low ovarian reserve, & the success rate of IVF is also lower with increasing age. 
It must be noted that all it takes is one egg & one successful pregnancy. 
Science has advanced & there are several methods of IVF treatment, medical & surgical & combination of both helps in retrieval of few good quality eggs which can be used to fertilise with husbands’ sperm & lead to pregnancy. 
Even if we assume that IVF has a 50% success rate, you will appreciate that 50 out of 100 who conceive are those couple who had ZERO chance to conceive. 
Have faith in God & science; if you have any chance of getting pregnant, we will make it happen.