(After the age of 35, egg quality also begins to decline along with the decrease in the number of eggs in women). Approximately one third of women who seek medical attention for a child have DOR (low ovarian reserve). Although ovarian reserve decreases, DOR (low ovarian reserve) may be overlooked because women can continue to have regular menstrual periods during this period. DOR (low ovarian reserve) decreases the chance of becoming pregnant and increases the rate of pregnancies ending in miscarriage. In those with DOR, the decrease in pregnancy rates and the increase in miscarriage rates become much more pronounced if the woman is older.
Ovarian Reserve Tests;
AMH (anti-mullerian hormone), Fah, E2. It is the number of antral follicles (egg sacs) seen on transvaginal ultrasound.
What are the causes of low ovarian reserve?
-Reserve reduction due to normal aging process
– Treatments such as chemotherapy or radiotherapy; Previous ovarian surgery
– Endometriosis (Chocolate cysts), Genital infections
– Genetic diseases
– Smoking and alcohol consumption; Excessive stress; Obesity
– The rate of decreased reserves without a cause is quite high
What are the symptoms of low ovarian reserve?
Unfortunately, many women may not have any signs or symptoms of low ovarian reserve. As the condition progresses, women may notice a shortening of their menstrual cycle (e.g., 28-day cycles may become shorter; periods may become more frequent or less frequent). Later, as menopause approaches, women may notice symptoms of low estrogen, such as hot flashes, trouble sleeping, missed periods, and vaginal dryness.
In Low Reserve;
AMH E2 and antral follicle count decreases in ultrasound while FSH increases. Here, when there are cysts or dominant follicles in the ovaries, FSH may be misleading by being lower than it should be. AMH test performed in reliable laboratories and AF count in ultrasound are much more sensitive indicators.
In women with good eggs, it is expected to have 7-8 AF in the ovary with a strike.
Although the AF counts seen from month to month may vary, seeing 3-4 AF may indicate that the reserve has roughly halved.
Although low ovarian reserve does not mean that spontaneous pregnancy will not occur; sometimes, since the reserve may continue to decrease rapidly,
it seems a rational approach to accelerate the treatment stages without leaving any risks and to manage the treatment process in a way that will support the couple to have their baby quickly and effectively.