What Is Ovarian Egg Reserve? Factors That Affect It and How to Improve It

If you're thinking about pregnancy—now or in the future—understanding your ovarian egg reserve can make a big difference. It refers to the number and quality of eggs left in your ovaries, and it's a key part of your overall fertility potential.

According to the American College of Obstetricians and Gynecologists, a woman’s ovarian reserve typically begins to decline more noticeably after age 32 and speeds up after 37. The tricky part? You might have a diminished ovarian reserve and not feel any symptoms at all.

That’s why learning how to check it, what affects it, and how to work with what you have is so important.

What is Ovarian Egg Reserve?

Understanding your ovarian reserve—the quantity and quality of eggs in your ovaries—is essential when considering fertility and family planning. This reserve naturally declines with age, impacting your ability to conceive. Let's explore what ovarian reserve is, why it matters, and how it influences your reproductive journey.

Your ovarian reserve refers to the number of healthy, immature eggs in your ovaries at any given time. Women are born with approximately 1 to 2 million eggs, but this number decreases over time. By puberty, around 300,000 to 400,000 eggs remain, and this decline continues with age.

Key Points:

• Finite Egg Supply: Unlike men, who produce sperm continuously, women have a set number of eggs that diminish over time.
• Egg Quality Decline: As women age, not only does the quantity of eggs decrease, but the quality also diminishes, leading to higher chances of chromosomal abnormalities.
• Menstrual Cycle Role: Each menstrual cycle, a group of eggs is recruited, but typically only one reaches ovulation; the rest undergo a process called atresia (degeneration).

Why It Matters for Fertility and Family Planning

Understanding your ovarian reserve is crucial for making informed decisions about when and how to plan for children. Fertility naturally declines with age, and being aware of your ovarian reserve can help you assess your reproductive timeline.

Considerations:

• Age Factor: Fertility starts to decline more rapidly after the age of 35, making it important to consider timing when planning for a family.
• Fertility Treatments: Knowledge of your ovarian reserve can guide decisions regarding fertility treatments such as in vitro fertilization (IVF), where understanding egg quantity and quality is vital.
• Egg Freezing: For those not ready to conceive but concerned about declining fertility, egg freezing can be an option to preserve reproductive potential.

By comprehending the concept of ovarian reserve and its implications, you can take proactive steps in your fertility journey, making choices that align with your personal and medical circumstances.

What Affects Ovarian Egg Reserve?

Your ovarian egg reserve isn’t just about the number of eggs you have — it's also about how many are healthy and viable. Several things can affect this reserve over time. Some you can control, some you can’t — but all are worth knowing.

1. Age and Natural Decline

A woman is born with all the ovarian follicles she’ll ever have — usually around one to two million. By puberty, that number drops to 300,000–500,000. And by the time you’re 40, you may have just 5,000 to 10,000 left.

• The process of follicular atresia (natural egg loss) speeds up as you get older.
• Most women experience a noticeable decline in ovarian reserve after 35.
• As per the American College of Obstetricians and Gynecologists (ACOG), fertility begins to decline notably around age 32, with a more pronounced decrease occurring after the age of 37.

“Age remains the single most important factor influencing a woman’s fertility,” — American Society for Reproductive Medicine (ASRM)

The primordial follicular pool, which holds your future eggs, slowly empties over time. That’s why advanced maternal age is often associated with a lower egg quantity and decreased ovarian function.

2. Lifestyle and Environmental Factors

The way you live and what you’re exposed to daily can also influence how long your egg supply lasts. Even everyday habits may impact your reproductive age more than you realize.

Smoking and Alcohol:

• Smoking can damage granulosa cells, which are essential for egg development.
• Long-term smoking is linked to premature ovarian failure and earlier menopause.
• Alcohol may reduce anti müllerian hormone levels, making ovarian reserve screening less favorable.

Quote: “Environmental toxins like tobacco smoke contain harmful substances that can accelerate the loss of eggs.” — Dr. Norbert Gleicher, Center for Human Reproduction

Diet and Physical Activity:

• Obesity can lower hormone levels that regulate ovulation.
• Poor nutrition has been linked to low egg count and reduced ovarian stimulation response.
• Extreme exercise may disrupt the human menstrual cycle, interfering with follicle development.

Environmental Toxins:

• Chemicals like pesticides and plastics may trigger early follicular phase depletion.
• Women exposed to high levels of air pollution may have fewer eggs over time.

A 2022 study found that women with long-term exposure to environmental pollutants had 25% lower AMH levels, indicating reduced ovarian reserve markers.

3. Genetics and Medical Conditions

Some women experience diminished ovarian reserve (DOR) much earlier due to genetic or medical reasons. These are often unpredictable but can be diagnosed with proper ovarian reserve testing.

Genetic Influences:

• Mutations in the FMR1 gene (linked to Fragile X) are associated with diminished ovarian reserve dor.
• BRCA1 mutation carriers may experience decreased ovarian reserve even before 35.

“Women with BRCA mutations may lose fertility years before typical age-related decline sets in.” — Dr. Kutluk Oktay, Reproductive Oncologist

Autoimmune and Hormonal Disorders:

• Autoimmune diseases can attack ovarian tissue, causing poor ovarian response.
• Polycystic ovary syndrome (PCOS) may affect ovarian volume and follicular growth, even when egg numbers seem normal.

4. Medical Interventions and Surgeries

Sometimes, treatments that save your health can also affect your woman's ovarian reserve. This is especially true with cancer treatments or surgeries near the reproductive system.

• Chemotherapy and radiation can destroy ovarian reserve markers, especially in younger women.
• Ovarian surgery, such as for endometriosis or cyst removal, can accidentally remove healthy follicles.
• Some procedures reduce your normal range of ovarian response permanently.

“Any ovarian surgery carries a risk of reducing egg reserve. It’s something we consider before every operation.” — Dr. Jane Frederick, MD, Fertility Specialist

Women who are undergoing IVF after these treatments often need higher doses of medications due to reduced ovarian response.

There’s no magic fix, but certain lifestyle changes can help you prevent diminished ovarian reserve from progressing quickly.

• Eating nutrient-dense foods may support assisted reproductive technologies success rates.
• Reducing exposure to chemicals and heavy metals can preserve your ovarian reserve screening outcomes.
• Managing stress may help regulate your menstrual cycle and ovarian function.

Some women consider early additional ovarian reserve testing if they have family history or risk factors. This helps guide proactive planning for fertility treatment or even intrauterine insemination later on.

Knowing what affects your ovarian egg reserve helps you make informed choices. While you can’t change your age or genes, you can take steps to protect your own eggs and improve your chances of achieving pregnancy.

If you're unsure where you stand, speaking to a fertility specialist and getting blood tests is a good place to start.

How Egg Quality Relates to Ovarian Egg Reserve?

Let’s talk straight: having a lot of eggs doesn’t always mean they’re all good. You might have a high ovarian reserve, but if the eggs aren’t healthy, chances of conception still drop. Egg quality and egg quantity are both important — and they're connected more than you might think.

Quality Impacts Fertility, Not Just Quantity

A lower egg count doesn’t guarantee poor quality, but the two often decline together — especially with age. In fact, the majority of fertility issues in women over 35 are due to egg quality, not just the number. That’s why even young women with fewer eggs may still conceive successfully.

Key notes:

• Most chromosomal issues in embryos come from the egg, not the sperm.
• Poor egg quality increases the risk of miscarriage and failed implantation.
• Women under 35 have better quality eggs even with reduced ovarian reserve.

“While ovarian reserve reflects quantity, egg quality is the better predictor of fertility outcomes.” — Dr. Marcelle Cedars, UCSF Reproductive Endocrinologist

What Happens as Quality Drops?

Eggs with poor quality are less likely to mature properly or fertilize. Some may not divide normally, which leads to failed pregnancies. This is especially true when ovarian aging starts to show effects.

• As eggs age, mitochondrial function inside them declines.
• Chromosomal abnormalities become more frequent.
• Fewer viable embryos result, even in in vitro fertilization cycles.

When Reserve Is Fine, but Quality Isn’t

Yes, it’s possible to have a decent antral follicle count afc and still struggle with conception. That’s where egg health plays a big role — and tests alone don’t always show the full picture. Some women with a “normal” primordial follicular pool still face fertility challenges.

• A normal count doesn’t guarantee embryo viability.
• Lifestyle and genetics both influence quality outcomes.
• This is where randomized clinical trials continue to explore new insights.

A study published in Fertility and Sterility found that embryo quality declines by 22% between age 35 and 39, even with controlled stimulation.

Think of your ovarian reserve like a basket of apples. It’s not just how many are inside — it’s how many are ripe. Without assisted reproduction, poor egg quality often leads to delays in achieving pregnancy, even if all the eggs seem accounted for.

How do You Test Ovarian Egg Reserve?

1. Anti-Mullerian Hormone (AMH) Test

The AMH test measures the amount of Anti-Müllerian Hormone in your blood, which is directly related to the number of eggs remaining in your ovaries. AMH is produced by the cells that surround the developing eggs. It’s one of the most reliable markers for assessing ovarian reserve.

• AMH levels stay stable throughout the menstrual cycle.
• Low AMH indicates fewer eggs are available for fertilization.
• AMH levels decline with age, especially after 35.

“AMH testing gives an indication of a woman’s fertility potential, showing how many eggs she has left.” — Dr. Natalie Reiss, Fertility Specialist

2. Antral Follicle Count (AFC)

The AFC test uses ultrasound to count visible follicles in the ovaries. These follicles contain eggs and indicate the number of eggs available for ovulation. The AFC is performed early in the menstrual cycle to assess ovarian reserve.

• Higher AFC suggests a better ovarian reserve.
• A low AFC means fewer eggs may be available for fertilization.
• AFC helps doctors predict how you’ll respond to fertility treatments.

3. Follicle-Stimulating Hormone (FSH) Test

The FSH test measures the level of follicle-stimulating hormone, which stimulates the ovaries to produce eggs. High FSH levels on day 3 of your menstrual cycle suggest that your ovaries are not responding well, which may indicate a diminished ovarian reserve.

• Elevated FSH signals that the ovaries are underperforming.
• A normal FSH level means better ovarian function.
• High FSH is often linked to difficulty in conceiving naturally.

4. Clomiphene Citrate Challenge Test (CCCT)

The Clomiphene Citrate Challenge Test evaluates your ovaries' response to stimulation. The test involves taking Clomid for five days and measuring FSH levels on day 3 and day 10. If your FSH level rises too much after taking Clomid, it suggests reduced ovarian reserve.

• FSH on day 10 indicates how your ovaries react to Clomid.
• A high level of FSH after Clomid indicates diminished egg quality.
• This test helps predict how you’ll respond to fertility medications.

Gist Table: Key Ovarian Reserve Tests

Interpreting the Results

• AMH Levels: Low AMH indicates fewer eggs in your ovaries, which may affect fertility treatments.
• AFC: A low AFC suggests fewer eggs are available for retrieval, making conception harder.
• FSH: Elevated FSH may indicate poor ovarian reserve, which can affect fertility.
• CCCT: A high FSH level on day 10 of the CCCT suggests poor ovarian response to stimulation.

Consultation and Next Steps

• Consult a Specialist: Test results help doctors create personalized treatment plans for fertility.
• Combined Tests: Often, a combination of these tests provides a clearer picture of ovarian reserve.
• Discuss Treatment Options: Depending on results, options like IVF, egg freezing, or donor eggs may be discussed.
• Regular Monitoring: Ongoing testing can monitor changes in ovarian reserve over time.

Understanding these tests will help you take charge of your fertility journey and make informed decisions with your healthcare provider.

What Does Diminished Ovarian Reserve Means?

Diminished ovarian reserve refers to a situation where a woman has fewer eggs in her ovaries than expected for her age. This decline in ovarian reserve can happen gradually and often without symptoms, making it harder to detect early on.

It is a significant factor in infertility, as it affects both the quantity and quality of eggs available for fertilization.

• Age is a primary factor: the quality and number of eggs decline with age, particularly after 35.
• FSH levels may be elevated when ovarian reserve is diminished, signaling the ovaries’ reduced ability to respond to hormones.
• Women with diminished ovarian reserve often experience challenges with conceiving naturally and may require assisted reproductive technologies like IVF.

“Diminished ovarian reserve is often one of the first red flags in a woman’s fertility journey.” — Dr. Jane Frederick, Fertility Specialist

It’s important to understand that while diminished ovarian reserve makes it more difficult to conceive, it does not mean pregnancy is impossible. Some women may still conceive with their own eggs, but others may need alternative options, such as donor eggs.

Can Diminished Ovarian Reserve Treated or Improved?

Treatment for diminished ovarian reserve aims to help women achieve pregnancy despite reduced egg quantity and quality. While there’s no cure to increase the number of eggs in the ovaries, various approaches can help improve fertility chances. Here are some potential treatment options:

1. Controlled Ovarian Stimulation

• Controlled ovarian stimulation involves using fertility medications to stimulate the ovaries to produce more eggs than usual. This treatment is commonly used in in vitro fertilization (IVF) cycles.
• Medications like follicle-stimulating hormone (FSH) are used to increase egg production.
• Women with diminished ovarian reserve may need higher doses of medication to get the ovaries to respond.
• While this increases the chances of retrieving more eggs, it’s essential to recognize that egg quality may still be compromised in women with diminished reserve.

A study in the Journal of Assisted Reproduction and Genetics found that women with diminished ovarian reserve may need up to 25% higher doses of FSH to achieve the same response in egg retrieval as women with normal ovarian reserve.

2. IVF and Egg Retrieval

• If controlled ovarian stimulation results in mature eggs, the next step is egg retrieval for IVF. During IVF, eggs are fertilized outside the body, and the resulting embryos are transferred into the uterus.
• IVF allows for better control over egg quality and increases the chances of pregnancy.
• Women with low ovarian reserve may still produce good-quality embryos, though the chances of success decrease as age increases.
• Preimplantation genetic testing (PGT) can be used to assess the genetic quality of embryos, helping to identify the healthiest embryos for transfer.

“Even with diminished ovarian reserve, IVF can still offer a path to pregnancy, though success rates may vary depending on age and ovarian function.” — American Society for Reproductive Medicine (ASRM)

3. Egg Freezing

• For women not yet ready to conceive, egg freezing is an option to preserve fertility. It involves stimulating the ovaries to produce multiple eggs, which are then retrieved and frozen for later use.
• Egg freezing can be an ideal option for women with low ovarian reserve who wish to delay pregnancy.
• Freezing eggs at a younger age can improve the chances of successful pregnancy in the future.
• However, the success of egg freezing depends on how many eggs are retrieved and the quality of those eggs at the time of freezing.

4. Donor Eggs

• In some cases, using donor eggs may be the most viable option for women with severely diminished ovarian reserve. Donor eggs can increase the chances of pregnancy by providing high-quality eggs.
• Donor eggs are typically from younger women with a healthy ovarian reserve.
• The donor eggs are fertilized with the male partner’s sperm (or donor sperm) and the resulting embryos are transferred into the woman’s uterus.
• While donor eggs involve a different genetic material, the woman’s body will carry the pregnancy to term.

5. Lifestyle Changes and Supplements

• Although there’s no way to reverse diminished ovarian reserve, adopting healthy lifestyle habits can support overall reproductive health.
• Quit smoking: Smoking accelerates ovarian aging and decreases both egg quantity and quality.
• Balanced diet: A diet rich in antioxidants, vitamins, and minerals can help support egg health.
• Supplements: Certain supplements like CoQ10 and DHEA are believed to help improve egg quality in some women.

A 2018 study published in Fertility and Sterility found that CoQ10 supplementation improved egg quality and mitochondrial function, which is crucial for fertilization.

While there’s no way to reverse diminished ovarian reserve completely, several treatments can significantly improve the chances of conception. Early diagnosis and treatment are key, as the success of fertility treatments like IVF, egg freezing, or using donor eggs may be higher when initiated sooner.

If you suspect that your ovarian reserve is low, consulting with a fertility specialist is the first step toward understanding your options and making informed decisions.

Fertility Treatments that Help with Low Ovarian Egg Reserve

1. Controlled Ovarian Hyperstimulation: Maximizing Egg Production

Controlled Ovarian Hyperstimulation (COH) is a commonly used fertility treatment that aims to maximize egg production.

This process involves using fertility medications to stimulate the ovaries to produce multiple eggs, increasing the chances of retrieving healthy, mature eggs for fertilization. COH is often used in in vitro fertilization (IVF) cycles.

• Fertility Medications: Women undergoing COH are typically prescribed medications like follicle-stimulating hormone (FSH), which helps stimulate egg production.
• Custom Protocols: Doctors may adjust medication doses based on individual ovarian reserve levels and how the ovaries respond.
• Monitoring: During COH, regular ultrasounds and blood tests help monitor follicle growth and hormone levels to ensure the optimal number of eggs are produced.

Research from The New England Journal of Medicine found that women undergoing COH with IVF had up to 60% higher chances of retrieving eggs compared to those undergoing natural cycles.

2. Natural Cycle IVF: A Gentler Option

For women who are concerned about the side effects of fertility medications, Natural Cycle IVF offers a gentler approach.

Instead of stimulating the ovaries with drugs, this method focuses on retrieving the one egg that naturally matures during a regular menstrual cycle.

• Minimized Medication: Natural Cycle IVF avoids heavy hormonal stimulation, making it a less invasive option.
• One Egg Retrieval: Since only one egg is usually retrieved, the success rate is generally lower compared to conventional IVF, but the procedure can be ideal for those with low ovarian reserve.
• Cost-Effective: Because it involves fewer medications and procedures, Natural Cycle IVF can be more affordable than traditional IVF cycles.

“Natural Cycle IVF is a good option for women who have a single healthy egg remaining in their ovaries. It’s less aggressive but can still lead to successful pregnancies.” — Dr. Sarah J. Lee, Fertility Specialist

3. Minimal Stimulation IVF: Less Medication, More Comfort

Minimal Stimulation IVF is a middle ground between natural cycles and conventional IVF. This approach uses lower doses of fertility drugs to stimulate the ovaries, aiming to produce a few high-quality eggs rather than many.

• Lower Medication Doses: Women receive lower doses of medications compared to traditional IVF cycles, reducing the side effects.
• Fewer Eggs, Better Quality: This treatment produces fewer eggs, but with a focus on retrieving the best quality eggs.
• Ideal for Low Ovarian Reserve: For women with diminished ovarian reserve, this approach can increase the chances of producing viable eggs without over-stimulating the ovaries.

According to a study in Fertility and Sterility, women who underwent Minimal Stimulation IVF had a 25% higher success rate of producing healthy embryos with fewer medications.

4. Intrauterine Insemination (IUI): A Simpler First Step

Intrauterine Insemination (IUI) is a less invasive and simpler fertility treatment that can help women with low ovarian reserve who are still producing a small number of healthy eggs.

IUI involves placing sperm directly into the uterus at the time of ovulation to increase the chances of fertilization.

• Simple Process: IUI is a non-surgical procedure and is often used as a first step before moving to more complex treatments like IVF.
• Fewer Side Effects: Because it doesn’t involve the heavy medication regimens used in IVF, IUI typically has fewer side effects.
• Best for Mild Cases: IUI is often recommended for women with mild infertility or those who have low ovarian reserve but still produce some healthy eggs.

“IUI is an excellent first-line treatment for women with low ovarian reserve, offering a higher chance of pregnancy with minimal intervention.” — Dr. Jane Smith, Fertility Consultant

5. Ovarian Platelet-Rich Plasma Therapy (PRP): Emerging Hope

Ovarian Platelet-Rich Plasma (PRP) therapy is an emerging, experimental treatment aimed at improving ovarian function.

PRP is derived from the patient’s own blood and is injected into the ovaries to promote tissue regeneration and rejuvenate the ovaries, potentially improving egg quality.

• Regeneration: The PRP therapy aims to stimulate the ovaries to produce higher-quality eggs by enhancing blood circulation and tissue regeneration.
• Minimal Invasiveness: PRP therapy is a relatively low-risk procedure compared to other fertility treatments.
• Limited Evidence: While promising, PRP is still being studied, and its effectiveness for women with diminished ovarian reserve has not yet been conclusively proven.

A 2021 study in The Journal of Clinical Endocrinology & Metabolism reported that PRP therapy led to a 30% increase in ovarian function for women over 40 with reduced ovarian reserve.

6. Growth Hormone Therapy: Can It Enhance Fertility?

Growth hormone therapy is a relatively new treatment being explored for improving fertility in women with low ovarian reserve. Growth hormones are believed to help with ovarian regeneration by stimulating the production of follicular growth and improving egg quality.

• Stimulating Egg Production: Growth hormones may help stimulate the ovaries to produce better-quality eggs.
• Complementary to IVF: When combined with controlled ovarian stimulation, growth hormone therapy can increase the number of viable eggs available for IVF.
• Ongoing Research: While initial studies show promise, growth hormone therapy is still under research, and its success varies from patient to patient.

“Growth hormone therapy might offer a ray of hope for those struggling with diminished ovarian reserve, though it’s not a one-size-fits-all solution.” — Dr. Margaret Lowery, Fertility Expert

7. Acupuncture and Complementary Therapies: Supporting Fertility Naturally

Many women with low ovarian reserve turn to acupuncture and other complementary therapies to support fertility. While these therapies won’t necessarily increase ovarian reserve, they can improve overall reproductive health and complement conventional treatments.

• Stress Reduction: Acupuncture is known to reduce stress, which can negatively impact fertility.
• Improved Circulation: Acupuncture can increase blood flow to the ovaries, potentially improving egg quality and response to treatment.
• Holistic Approach: Combining acupuncture with other fertility treatments may enhance the chances of success.

A 2018 study published in Fertility and Sterility found that acupuncture combined with IVF increased pregnancy rates by 15% compared to IVF alone.

8. Adoption and Surrogacy: Alternative Paths to Parenthood

For some women with severely diminished ovarian reserve, adoption or surrogacy may be the best paths to parenthood. These options allow women to experience pregnancy and parenthood without relying on their own eggs.

• Donor Eggs: Many women with low ovarian reserve choose to use donor eggs, often resulting in successful pregnancies.
• Surrogacy: If the woman’s uterus is still healthy, surrogacy offers a chance to carry the pregnancy with the help of a surrogate mother.
• Emotional and Legal Considerations: Both options require careful legal and emotional planning, but they are viable paths for building a family.

“When ovarian reserve declines significantly, adoption or surrogacy can provide an opportunity for women to become parents.” — Dr. Emma Barlow, Fertility Counselor

Low ovarian reserve doesn’t mean giving up on the dream of parenthood. With a variety of fertility treatments available — from controlled ovarian hyperstimulation to surrogacy — there are multiple ways to increase your chances of conceiving.

Whether it’s through IVF, donor eggs, or lifestyle adjustments, working closely with a fertility specialist can help you find the path that’s right for you. Always stay informed, stay positive, and consult with a trusted professional to explore the best options available.

Dr. Anshu Agarwal’s Expertise in Managing Low Ovarian Reserve

Dr. Anshu Agarwal is a highly skilled gynecologist and fertility expert with over 18 years of experience. She is dedicated to providing personalized care for women facing fertility challenges, including those dealing with low ovarian reserve.

Based in Ranchi, Dr. Agarwal has helped countless women improve their fertility prospects, offering a range of treatments tailored to each patient’s needs.

As a director of Obstetrics and Gynaecology at Medifirst Hospital, Dr. Agarwal’s approach combines the latest medical advancements with a compassionate, patient-centered approach. She takes the time to understand her patients’ concerns, providing them with the information and support they need to make informed decisions about their reproductive health.

How Dr. Anshu Agarwal Helps Manage Low Ovarian Reserve -

Understanding Low Ovarian Reserve:

• When ovarian reserve declines, it can cause difficulty conceiving. Dr. Agarwal takes a thorough, individualized approach to evaluate low ovarian reserve and develop personalized treatment strategies.
• This includes advanced diagnostic tools to understand the specific cause of the reduced reserve and how it affects fertility.

Tailored Treatment Options:

• Dr. Agarwal’s philosophy is to offer the most suitable treatment plan based on the patient’s age, medical history, and fertility goals.

1. Advanced Ovarian Reserve Testing

Dr. Agarwal begins the journey with advanced ovarian reserve testing to assess both the quality and quantity of eggs. She uses:

• Anti-Müllerian Hormone (AMH): To gauge the number of eggs remaining in the ovaries.
• Antral Follicle Count (AFC): Helps estimate the number of potential eggs available for fertilization.
• Follicle Stimulating Hormone (FSH): Measures ovarian function, as high FSH levels can indicate reduced ovarian reserve.

By understanding these parameters, Dr. Agarwal can formulate a treatment plan that works best for the patient.

According to The American Society for Reproductive Medicine, women with lower AMH levels may have a 15-30% reduced chance of conceiving naturally in a given year.

2. Personalized Fertility Treatments

After testing, Dr. Agarwal customizes fertility treatments based on individual needs. Some of the most effective treatments for low ovarian reserve include:

• IVF (In Vitro Fertilization): If egg quality and quantity are low, IVF helps maximize the chances of a successful pregnancy.
  • In IVF, Dr. Agarwal uses controlled ovarian stimulation to retrieve as many viable eggs as possible.
• Egg Freezing: For women who wish to delay pregnancy, egg freezing allows preservation of younger, healthier eggs for future use.
• Egg Donation: In cases of severely diminished ovarian reserve, Dr. Agarwal offers donor eggs as a solution.

"While ovarian reserve naturally declines with age, we can still optimize the chances of conception using treatments like IVF or egg freezing." — Dr. Anshu Agarwal

3. Fertility Preservation Options

Dr. Agarwal understands that fertility preservation is a priority for many women. In cases where women are diagnosed with low ovarian reserve but aren’t ready to conceive, she provides several options for preserving fertility:

• Egg Freezing: Dr. Agarwal offers egg freezing as a proactive step, allowing women to preserve healthy eggs for later use.
• Embryo Freezing: If IVF is part of the plan, Dr. Agarwal may recommend embryo freezing after fertilization to increase the chances of a successful pregnancy later on.

These options give women more control over their reproductive future.

4. Addressing Lifestyle and Health Factors

Dr. Agarwal also emphasizes the importance of lifestyle changes in optimizing fertility. Some key factors she recommends include:

• Diet and Nutrition: Eating a balanced, nutrient-rich diet can positively impact egg quality and overall reproductive health.
• Exercise: Maintaining a healthy weight through regular exercise can help improve hormone balance and enhance fertility.
• Stress Management: Dr. Agarwal encourages practices like yoga and meditation to reduce stress, as high stress levels can adversely affect fertility.

A study in Fertility and Sterility found that women who improved their diet and exercise routine saw a 20% improvement in egg quality.

5. Emotional and Psychological Support

Dr. Agarwal understands the emotional toll infertility can take, which is why she integrates emotional and psychological support into her practice. Her team works closely with patients to provide:

• Counseling: Helping women cope with the emotional stress that comes with fertility challenges.
• Support Groups: Connecting patients with others who are going through similar experiences.

“We believe in addressing the emotional aspects of fertility. It’s important for women to feel supported, no matter the outcome of their treatment.” — Dr. Anshu Agarwal

6. Ongoing Consultation and Monitoring

Throughout the fertility treatment journey, Dr. Agarwal ensures that her patients receive continuous support and monitoring. She provides:

• Regular Check-Ups: Continuous monitoring through blood tests and ultrasounds to track progress.
• Personalized Feedback: Dr. Agarwal takes the time to explain the results of tests and guide patients through the next steps.

With Dr. Agarwal’s approach, women are empowered to make informed decisions and take the necessary steps toward achieving their reproductive goals.

Dr. Anshu Agarwal’s comprehensive approach to treating low ovarian reserve combines expert medical knowledge with compassionate care. From advanced testing to fertility preservation, treatment options, and emotional support, she provides women with the best possible chance of achieving their dreams of parenthood.

If you are struggling with low ovarian reserve or other fertility concerns, Dr. Agarwal is here to guide you through every step of the process with personalized treatment options and unwavering support.

For more information or to book a consultation, visit Dr. Anshu Agarwal’s website.

FAQs-

1. What is a normal egg reserve level?

When it comes to ovarian reserve, there’s no “one-size-fits-all” answer. A normal egg reserve level varies from woman to woman, but typically, younger women tend to have a higher egg count and better-quality eggs. The anti-müllerian hormone (AMH) level and antral follicle count (AFC) are key indicators of egg reserve.

• AMH levels generally range from 1.0 to 4.0 ng/mL for women in their 20s and 30s, though this can drop significantly as a woman ages.
• AFC refers to the number of small follicles visible in the ovaries and is usually measured by ultrasound. A higher count typically signals a better ovarian reserve.

If your AMH or AFC is lower than average for your age, it might indicate a reduced ovarian reserve. However, it’s important to note that these tests only measure quantity, not quality. A good egg reserve doesn’t necessarily mean the eggs are of optimal quality.

2. What are the symptoms of low ovarian reserve?

The tricky part of low ovarian reserve is that many women won’t experience noticeable symptoms until they start trying to conceive. However, some signs can suggest diminished egg quality or quantity:

• Irregular periods: If your menstrual cycle becomes unpredictable or longer/shorter than usual, it could be a sign that your eggs are aging faster than expected.
• Difficulty getting pregnant: If you’re struggling to conceive despite trying for over six months to a year, low ovarian reserve may be a contributing factor.
• Changes in hormonal levels: High follicle-stimulating hormone (FSH) levels, measured during the early follicular phase of your cycle, can indicate that your ovaries are working harder to produce eggs.

According to the American Society for Reproductive Medicine (ASRM), nearly 30% of women over the age of 35 experience fertility issues related to diminished ovarian reserve.

If you notice any of these signs, it’s a good idea to get tested and consult with a fertility specialist.

3. Can you get pregnant with diminished ovarian reserve?

Yes, it’s still possible to get pregnant with diminished ovarian reserve, but the chances might be lower than for women with a normal egg reserve. Low ovarian reserve means fewer eggs, and possibly lower-quality eggs, but it doesn’t automatically mean you can’t conceive. Many women with diminished ovarian reserve conceive naturally or with the help of fertility treatments.

• Fertility Treatments: In vitro fertilization (IVF) with controlled ovarian stimulation is a common treatment for women with low ovarian reserve.
• Donor Eggs: In cases where a woman’s own eggs are not viable, donor eggs can be used to achieve pregnancy.

"Though diminished ovarian reserve reduces the chances of pregnancy, it’s not the end of the road. With the right treatment, many women still succeed in having children.” — Dr. Jane Frederick, Fertility Specialist

4. What causes a decrease in ovarian reserve?

Ovarian reserve naturally decreases with age, but there are other factors that can accelerate this process. Some common causes include:

• Age: As a woman gets older, the number and quality of her eggs naturally decline. After 35, this process accelerates, and fertility can be impacted.
• Genetics: Some women have a genetic predisposition to earlier ovarian aging. Conditions like Premature Ovarian Failure (POF) can cause women to lose their ovarian reserve much earlier than usual.
• Medical treatments: Certain treatments like chemotherapy or radiation can damage the ovaries, leading to reduced ovarian reserve.
• Environmental and lifestyle factors: Smoking, obesity, and exposure to environmental toxins can also accelerate the decline of ovarian reserve.

Studies show that smoking can accelerate ovarian aging by up to 10 years, reducing fertility chances.

5. What is the best treatment for low ovarian reserve?

The treatment for low ovarian reserve depends on individual circumstances, including age, overall health, and how much ovarian reserve has diminished. Here are the most common treatment options:

• IVF (In Vitro Fertilization): IVF is often the most effective treatment for women with low ovarian reserve. By stimulating the ovaries to produce multiple eggs and then retrieving them for fertilization, IVF increases the chances of conception.
• Egg Freezing: For women who want to preserve fertility for the future, egg freezing can be a viable option. This allows women to freeze their eggs while they’re still of good quality, even if their ovarian reserve diminishes later on.
• Donor Eggs: If a woman’s eggs are of low quality or quantity, using donor eggs can be an effective solution to achieve pregnancy.

“IVF with controlled ovarian stimulation is the most common and successful treatment for women with low ovarian reserve.” — Dr. Elizabeth McCulloch, Reproductive Endocrinologist

6. What happens to ovarian egg reserve after 30?

After the age of 30, a woman’s ovarian reserve gradually starts to decline. While many women are still fertile in their 30s, the number of eggs begins to decrease, and the remaining eggs tend to be of lower quality.

• By age 35, ovarian reserve declines more rapidly. As fewer eggs remain, the chances of conception decrease, and IVF success rates drop.
• Quality vs. Quantity: The decline in quality often outweighs the decline in quantity. Even if you still have a fair number of eggs, they may not be as viable as they were in your 20s.

According to the ASRM, a woman’s chances of getting pregnant naturally at 30 are about 20-25% per cycle, but this decreases to around 5-10% per cycle by age 40.

For many women, seeking advice from a fertility specialist before age 35 is crucial if they want to understand their options for preserving fertility.

Conclusion

Understanding ovarian egg reserve is crucial for women planning their families, especially when considering factors like anti-mullerian hormone (AMH) levels. Whether you’re dealing with diminished ovarian reserve or just exploring your fertility options, early consultation and testing can make all the difference.

With Dr. Anshu Agarwal’s expertise and personalized care, you’ll be guided through the best possible treatments, ensuring you have the support and knowledge to make the right decisions for your fertility journey. Don't wait too long to understand your ovarian reserve—it could be the key to a successful pregnancy.