Eggs are formed in the follicles of the ovaries, and the process of formation begins in the 11th-12th week of pregnancy in girls. By the time of birth, the number of eggs decreases from 6-7 million to 1-2 million. At the moment of the first menstruation, their number is 250-400 thousand. Throughout life, the number of eggs decreases with each menstruation, even if a woman is healthy.
For various reasons, the ovarian reserve can be depleted more quickly. In this case, a woman may have a problem with conception. The possibility of natural pregnancy is reduced if a woman has a proven low ovarian reserve.
What can be the reason for the reduction of ovarian reserve?
A decrease in egg supply can occur for various reasons. The cause can be natural or pathological. Between them:
– natural decline of fertility, which occurs with the age of a woman;
– Previous surgical interventions on ovaries related to tumor removal;
-Cauterization in relation to the formation of cysts;
– autoimmune pathologies;
– mental disorders;
– inflammatory processes of genital organs;
– Chemotherapy and radiation therapy;
– work in radiation production;
– hard physical work;
– Hereditary factors (low supply of eggs at birth);
– presence of harmful habits: alcohol and drug addiction, smoking;
-Embolization of uterine blood vessels and others
How is reserve reduction manifested?
The reduction of the ovarian reserve does not have any symptoms. Pathology can be detected only with the help of laboratory tests and ultrasound results. There are certain signs that are not specific to this pathology. these are:
– lack of menstruation or irregular cycle;
– decrease in sexual desire;
– reduction of the size of mammary glands;
– Disorders of the nervous system
To determine the ovarian reserve, a woman’s examination is carried out by the following methods:
– Blood biochemical test for hormones:
– FSH study,
– Estradiol analysis,
– determination of AMH (anti-Müllerian hormone) levels,
– Ultrasound, which allows you to determine the number of antral follicles.
Based on the received data, the doctor evaluates the current situation and draws a conclusion about the egg supply.
Is it possible for a woman to get pregnant with reduced ovarian reserve?
AMH indicator plays an important role in diagnosis.
AMH is considered the main marker of ovarian reserve. Normally, its value should not be lower than 1 ng/ml. As the body ages, anti-Müllerian hormone is produced in less and less quantity. With a decrease in the ovarian reserve, the AMH index is lower than normal. If it is higher, it means that the egg supply is good. A concentration of less than 0.3 ng/mL is considered critically low. In this case, it is not always possible to get an egg even after using stimulants. But here I want to tell you that AMH is only one of the indicators of egg reserve. Sometimes even with the lowest value of anti-Müllerian hormone, it is possible to get eggs.
In addition to anti-Müllerian hormone, estradiol and FSH also play an important role in infertility.
The role of FSH in ovarian reserve
The FSH index also reflects the egg supply. It is involved in regulating the activity of the ovaries, stimulating the maturation of follicles in them. In case of failure of egg supply, the level of FSH increases significantly. All the factors that may affect a woman’s ability to conceive should also be taken into account when the ovarian reserve is reduced. These are: age, genetic predisposition, presence of pathological conditions.
Is pregnancy possible with reduced ovarian reserve?
A natural pregnancy can occur in a woman with low ovarian reserve, but in very rare cases. We should also be aware of the fact that a small concentration of anti-Müllerian hormone is associated with a high risk of genetic disorders in the unborn child. The presence of a reduced ovarian reserve in a woman does not exclude the possibility of pregnancy, both naturally and with the help of assisted reproductive technologies (ART). Low AMH values are not a contraindication for their implementation.
However, all factors that can affect both the occurrence and management of pregnancy should be taken into account.
To date, there is no means that can be used to increase the number and quality of oocytes. In the absence of ovarian response to increased doses of stimulation drugs, in vitro fertilization with a natural cycle is more appropriate.
Recently we started using PRP technology. This is a type of therapy that uses the patient’s own blood to produce a high concentration of platelets. The technique involves injecting the patient’s own cells as growth factors into the damaged areas, causing the tissue to regenerate. It is believed that PRP-