What is Ovarian Reserve?

What is ovarian reserve? 

Ovarian reserve refers to the quantity and quality of eggs in a woman's ovaries that make up her fertility potential. Women are born with a certain number of eggs; this number naturally decreases with age. A decrease in this reserve can lead to a decrease in fertility capacity and the risk of early menopause. In other words, ovarian reserve is a critical parameter that directly affects both the chances of becoming a mother and the hormonal balance of a woman.

At what age does ovarian reserve decrease?

Traditionally, a serious decrease in ovarian reserve was expected after the age of 35. However, this picture has changed in recent years. Now, serious decreases in the number of eggs can be observed even in the late 20s and early 30s. This situation reveals the negative impact of environmental factors and changes in lifestyle on the reserve.

What are the Causes of Decreased Ovarian Reserve? 

Both genetic and environmental/lifestyle factors play a role in decreased ovarian reserve:

Genetic factors: The risk increases if there is a family history of early menopause.
Medical factors: Treatments such as chemotherapy, radiotherapy, ovarian surgeries.
Environmental factors: Radiation, air pollution, microplastic exposure.
Lifestyle: Conditions such as intense stress, unhealthy diet, smoking, insomnia negatively affect the quality and number of eggs.

What are the Symptoms of Decreased Ovarian Reserve?

When a woman's ovarian reserve starts to decrease, some symptoms are observed as follows. It is important to pay attention to these signals given by the body for early diagnosis.

• Frequent menstrual cycle (menstruation at intervals shorter than 21 days)
• Hot flashes
• Mood changes (irritability, fragility)
• Fatigue, feeling of weakness

What are the tests for ovarian reserve?

The most commonly used tests for the diagnosis of low ovarian reserve are as follows:

AMH (Anti-Müllerian Hormone): It is the blood test that most accurately shows ovarian reserve.
FSH and Estradiol: It is done on the 2nd or 3rd day of menstruation.
Antral Follicle Count (with Ultrasound): Small follicles seen in the ovaries are counted.

What treatment options are available for women with reduced ovarian reserve? 

Treatment and preventive options that can be recommended for women with reduced ovarian reserve are as follows:

Egg freezing: It is the most effective fertility preservation method for women who are not yet married or who do not want to have children.
In vitro fertilization (IVF): The most common assisted reproductive technique recommended for married couples.
Ovulation (ovulation) support therapies: Can be used in mild cases.
Lifestyle adjustments: May have a supportive effect on treatment.

What should be done to preserve ovarian reserve?

Although it is not possible to increase the ovarian reserve completely, the following lifestyle changes are useful to slow its decline and maintain its quality:

• Eat a healthy and balanced diet.
• Try to lead a stress-free life.
• Avoid smoking and alcohol.
• Avoid microplastics and toxins as much as possible.
• Sleep and exercise regularly.
• Avoid radiation sources.
• Annual gynecological check-ups should not be neglected.

Does low ovarian reserve definitely indicate infertility?

Of course not, low ovarian reserve does not necessarily mean infertility. However, in such a case, the woman's chance of pregnancy naturally decreases. There may also be a decrease in egg quality, which can jeopardize the development of healthy embryos and the continuation of pregnancy. Some women can become pregnant spontaneously despite a low reserve, but this is exceptional.