Weak Ovarian Reserve and IVF Treatment

Weak ovarian reserve is a common problem that affects many women. It is known that patients with weak ovarian reserve generally have a very low chance of pregnancy and an extremely high rate of spontaneous miscarriage. However, women with weak ovarian reserve can have children through in vitro fertilization.

Weak ovarian reserve and the main factors affecting this situation

1. Being over 40 years old
2. Previous use of fertility drugs that excessively induce ovulation
3. Birth control pills that suppress ovulation.
4. Increased need for specific nutrients and minerals.
5. Hormonal imbalance (high FSH and low estrogen and progesterone).
6. Stress and adrenal fatigue.

Age and poor ovarian reserve: It’s not what you think!

• All women over 40 have poor egg quality, and all women under 40 have poor eggs. There is a huge variation because there are many factors that affect ovarian health. Chronological age is one factor, but biological age is more important. How young your eggs are also depends on your lifestyle, toxicity levels, stress levels, nutritional levels, and medical history.
• During IVF treatments, overstimulation of the ovaries is necessary to stimulate the ovaries to release the required number of eggs. Naturally, the ovaries release one egg per cycle, but for IVF, the ovaries need to be stimulated to release a high number of eggs.
• Long-term use of birth control pills suppresses ovulation. When the ovaries are suppressed for a long time, they do not automatically respond to stimulation, they become lazy.
• Antioxidants reduce free radicals that cause aging and DNA damage.
• Damaged DNA (genetic material) is responsible for birth defects and chromosomal problems in babies born to older women. Antioxidants are also important for keeping sperm DNA in good condition.

Poor hormonal balance can lead to poor ovarian reserve!

Hormonal balance is especially important when it comes to poor ovarian response. When a woman produces too much Follicle Stimulating Hormone (FSH), her ovarian reserve is reduced. If progesterone and estrogen levels are lowered, ovulation may not occur.

Other factors that affect egg quality are an underactive thyroid, poor metabolic response to insulin, and high cortisol levels as a result of stress. Herbal remedies specific to female fertility can create hormonal balance, lowering high FSH and balancing estrogen and progesterone to establish regular ovulatory cycles.

Stress also affects IVF treatment!

Stress is definitely a factor in infertility. There are many effective ways to release stress to increase conception. Yoga is a very gentle form of exercise that helps to realign your body and mind, increase stamina, flexibility and most importantly, reduce stress levels and increase blood flow to the reproductive organs which stimulates ovulation.

What should be the ovarian reserve?

There are various tests that can be used to determine the quality and quantity of eggs.

Follicle Stimulating Hormone Test

Typically, levels of FSH (follicle stimulating hormone) in the blood are measured as an indicator of ovarian function. A high level suggests poor ovarian reserve. FSH is produced by the pituitary gland and is the hormone responsible for the growth of follicles in the ovary each month.

The ovarian follicles contain mature eggs that are released during ovulation. If low levels of FSH are required to stimulate ovulation each month, your eggs are healthy. If your pituitary gland needs to produce high levels of FSH for an egg to mature, you have an ovarian problem. In this case, the ovary needs higher levels of FSH to produce and release a healthy egg. Therefore, high FSH levels are not the cause of poor ovarian function, they are simply a natural body response.

Clomiphene Challenge Test

Another important test is the Comiphene Challenge Test to measure the ability of the ovaries to respond to fertility drugs such as clomiphene. This test unfortunately challenges the ovaries in a way that women with poorer ovarian response experience more ovarian dysfunction.

Anti-Müllerian Hormone Test

Anti-Müllerian Hormone is produced by the ovarian follicles and AMH levels are used to measure the number of antral follicles in the ovaries. Women with low AMH have fewer follicles and produce fewer eggs. AMH testing is increasingly used because Anti-Müllerian Hormone levels do not change significantly throughout the menstrual cycle and can be measured at any time during the menstrual cycle. Lower levels are found in older women (over 38) while higher levels are found in women with PCOS. Normal AMH levels are: 2.0 – 6.8 ng/ml. It is important to realise that a woman with low AMH levels can still conceive naturally. This test is used to assess fertility potential in relation to ovarian response during IVF treatments.