What is Ovarian Reserve?
You are born with all the eggs that you will ever produce and that number decreases by the hundreds every month. As a woman, your fertility potential is largely determined by your ovarian reserve. Ovarian reserve refers to the number of eggs you carry in your ovaries, as well as the health and quality of those eggs.
Assuming no other reproductive problems exist, ovarian reserve plays a large role in determining whether you will get pregnant or not. Your ovarian reserve depends not only on the quantity and quality of the eggs in your ovaries, but also on the quality of the response of ovarian follicles to hormone signals from the brain.
What is ovarian reserve testing?
Doctors can perform numerous blood and imaging tests to try to determine your ovarian reserve. These tests are performed on specific days of your menstrual cycle and include blood tests to determine levels of several hormones, including the following hormones:
- Follicle stimulating hormone (FSH)
- Estradiol (E2)
- Antimullerian hormone (AMH)
An ultrasound can also be performed to measure the ovary size and number of antral follicles.
Fertility treatments for diminished ovarian reserve
Once a diminished ovarian reserve (DOR) has been established, there is no medical intervention that can reverse the damage. However, doctors may offer you one of several fertility treatment options.
One option is to stimulate your ovaries using high doses of fertility drugs such as gonadotropins (luteinizing hormone and FSH). Generally, that treatment is also used in conjunction with giving you various other medications such as oral contraceptives, Lupron, clomiphene or Antagon.
If ovarian response does not improve after those treatments, you may consider trying an in vitro fertilization cycle using donor eggs in the hopes of achieving a successful pregnancy.
Egg donation accounts for approximately 10 percent of all assisted reproductive technology (ART) procedures. Donor egg cycles have high success rates, at over 55% for fresh embryos and 35% for frozen and thawed embryos.
Egg donation for women over 40
If you are over 40 and interested in using donor eggs with IVF, both you and the donor will undergo thorough evaluations to ensure optimal results. You will be given dosages of estrogen and progesterone before, during and after the procedure in order to provide the optimal environment for an embryo.
Egg donation poses minimal risks to recipients. The principal risk is becoming pregnant with multiples. If you are over 40, your chances of having a healthy baby are increased when using donor eggs. The risks of miscarriage and having a baby with chromosomal abnormalities like Down syndrome are greatly reduced.Sources
- American Society for Reproductive Medicine: Age and Fertility. A Guide for Patients.
- IntegraMed: Can We Wait to Get Pregnant?
- IntegraMed: Fertility over 40- Age-Related Infertility Female Infertility: Tests and Diagnosis
- RESOLVE: The Medical Aspects of Egg Donation
- MarchofDimes.com: Pregnancy after 35