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Reduced ovarian reserve: what does that mean?



Trying to Understand is one of the weirdest things that is incredibly easy and frustratingly difficult for some people. If you fall into the latter camp, you may eventually choose medical tests to find out where you and your partner are fertile.

Reproductive science has evolved to a point where there is a wide range of fertility testing tests, some of which can assess the status of your ovaries. If your doctor gets a message after testing that you have a reduced ovarian reserve, you may feel confused and worry about how your chances of conceiving could change. You should know the following.

Your ovarian reserve is essentially the number and quality of your eggs at a given time.

According to you were born with a certain number of eggs in your ovaries. American College of Obstetricians and Gynecologists (ACOG). This is your ovarian reserve.

If a doctor states that your ovarian reserve is low or diminished, it means that your eggs are lower in number or quality than your age would expect, Deidre Gunn, MD, a reproductive endocrinologist at the University of Alabama in Birmingham, tells SELF. (This is different from premature ovarian failure, which is a loss of normal ovarian function before you turn 40, says the Mayo Clinic .) In this phenomenon, your eggs do not produce normal amounts of hormone Estrogen or releasing eggs on a regular basis, which makes it difficult to get pregnant without reproductive support.)

To give you a background, if you have ovaries, your best reproductive years should typically be between your late teens and the late twenties Years after [19459004ACOG. As you pass this window, the number of eggs you have in your reserve naturally decreases. Their quality is therefore higher because the eggs you left behind have abnormal chromosomes that make conception difficult, ACOG . As a result, your ability to conceive decreases steadily from the age of 30, and decreases more from the time you reach your mid-30s. (This is a steady decline, not a fertility cliff that suddenly changes your chances of drastically changing at some point, says Dr. Gunn.) But it happens.) At age 45, it's unlikely that most women will get pregnant without any form of medical intervention such as IVF .

With all this in mind, a reduced ovarian reserve may mean that at the age of 30, the quality and quantity of your eggs is more typical for someone who is 45 years old, for example. This may be due to factors such as chemotherapy radiation, ovarian surgery (for an ovarian cyst or ovarian carcinoma ), mutations in genes that are related to ovarian function, and z endometriomas or cysts that are due of health condition Endometriosis . Some experts believe that pelvic inflammatory disease plays a role when bacteria spread to the reproductive system from an untreated STI. But sometimes doctors can not pinpoint the cause of someone's reduced ovarian reserve.

If you have a reduced ovarian reserve or you want to get pregnant but are worried about your age, those last few paragraphs may have been hard to mark. None of this means that you are destined for infertility when you get older or that you can not get pregnant if you do not have the normal amount or quality of eggs for your age. However, it is important to know these facts so that you can make the best choice when it comes to your fertility and medical care.

The time you need to wait to see a doctor if you're trying to keep up with breaks well beyond your age.

If you are under 35, it is recommended that you become pregnant for at least one year before seeing a fertility doctor, according to the Mayo Clinic . , If you are between 35 and 40 years old, it's six months. If you are over 40 and hope to get pregnant, tell your doctor as soon as possible if you want to get started right away. (To be clear, you should always tell your doctor that you want to get pregnant regardless of your age, but if you are under 40, it is recommended that you wait a certain amount of time It may also be advisable to ask after tests if you are under 40 years of age and had certain health problems, such as irregular or painful periods [] periods before you return if conception seems to take too long.) repeated miscarriages, or endometriosis, says the Mayo Clinic . And you can consult a doctor at any time, regardless of your age, if you only have the assurance that your fertility or other aspects of your health are in order. That's what they are for.

There are some tests that your doctor can perform to find out if you have a diminished ovarian reserve.

If your doctor is worried about your fertility, they will choose to test aspects based on factors such as your age, the time you spend with conception, and the history of your history.

When examining your ovarian reserve, a transvaginal ultrasound involving your doctor or an ultrasound technician may be performed. Inserting a device into your vagina to help you better see your ovaries (and other reproductive organs). That sounds awful, but at least it should not be uncomfortable physically. If you learn all about what to expect before, during, and after a transvaginal ultrasound, may also cause emotional distress.

A transvaginal ultrasound can help a doctor find your […] who tells you how many follicles you have in each ovary, says Alan B. Copperman, director of the Department of Reproductive Endocrinology at the Icahn School of Medicine on Mount Sinai, opposite SELF. At the beginning of your menstrual cycle these follicles, each containing an egg, begin to mature in preparation for ovulation. "[The ovarian antral follicle count] can add information about the ovarian reserve and can even predict how many eggs a woman will produce if she freezes egg or IVF," Dr. Copperman.

Your doctor can also order Gunn says, two different blood tests to examine your ovarian reserve. The content of follicle-stimulating hormone (FSH) in your blood is tested. At the beginning of your menstrual cycle the pituitary gland in your brain produces this hormone to form your ovaries to produce these egg-containing follicles for ovulation. This test is usually performed on the fourth day of your menstrual cycle, Dr. Tarun Jain, a specialist in reproductive endocrinology and infertility at Northwestern Medicine.

The other blood test looks for anti-Müllerian hormone (AMH), a protein that is produced by the cells surrounding each egg and can be produced at any point in your cycle. There are standard AMH levels for different age groups. Like your number of eggs, your protein level decreases with age. This makes it a pretty good indicator of fertility when compared to the other tests, says Dr. Gunn. "The important thing is that there is not a single test that measures your ovarian reserve perfectly," she says.

If you have a reduced ovarian reserve, your doctor can only do so much to help – but that does not mean you can not get pregnant.

"There is currently no known method to reduce the rate of egg loss," says Dr. Jain. Likewise, there is no magic pill to make new eggs.

Your doctor will probably recommend that you meet with a Fertility Specialist who can suggest the next steps depending on the severity of your situation. In many cases, you would need to take fertility drugs such as Clomiphene which stimulates ovulation, says Dr. Gunn. He added that the drug along with Intrauterine Insemination (IUI), where semen is inserted into your uterus to try to increase the likelihood that you will get pregnant in a given cycle.

If this does not work, or if your ovarian reserve is low enough, IUI can not do this. A good chance of success may be to recommend your doctor to go directly to In Vitro Fertilization where already fertilized eggs are implanted in the uterus ,

It is possible to have the IVF work with your own eggs. If not, your doctor may recommend that you consider using donation eggs. "The uterus fortunately does not age," says dr. Jain. "These donor eggs can be fertilized with the sperm of the partner, and the resulting embryo can be placed in the woman's uterus, with a very high probability of a successful pregnancy."

Again, it is entirely possible to have a diminished ovarian reserve, or to grasp it – even without reproductive support. "Getting pregnant is still possible," says Dr. Copperman. "The key is not to wait, get a formal evaluation from a specialist and take action."

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