How ovarian reserve decreases with age

Aging is the biggest enemy for female reproductive life, which starts with first menstruation and lasts till menopause. Today women are putting bigger effort on building career not family therefore getting married later than our ancestors did. We can postpone giving birth to our children, but it is not possible to stop our biological clock and activate it when we will feel ready.

Different from males, females lose fertility more rapidly, because of the ovaries, which age more quickly than uterus, the pituitary gland, pancreas or any other tissues in female body. Aging process effects both - the number and quality of the oocytes in the ovaries. They both decrease and reach to a point beyond that no more viable offspring may be produced.

There are women who still do proceed enough hormones to get their period, but having regular menstruations, does not show you what your egg reserves in ovaries is like, they still can be low.


Every woman can go through several tests that can assess a woman’s ovarian reserve. One of the most popular is AMH - Anti Mullerian hormone test. For this test, blood can be taken in any day of menstrual cycle, in 3rd day of the cycle it is possible to test FSH level (follicle stimulation hormone) and estradiol level. It is also possible to measure ovarian size and the number of antral (resting) follicles using vaginal ultrasound. Like the picture above shows, ovarian size and antral follicle count decrease with age and number of antral follicles correlates with the number of recruital and possibly fertilizable eggs.


After receiving the results of these tests, doctor recommends the most suitable treatment for the patients - IVF or Egg donation treatment. Egg donation treatment with young donor genetic material gives an opportunity to be a mother for the women, who cannot produce their own eggs anymore, but still can give the birth and raise a child.

As the quality of eggs is getting worse after age 35, it is important to be 100% sure that embryos, which will be used for the implantation, are genetically healthy and woman would not experience early miscarriage. Breaking 45-year’s border, only every 9th egg has been produced fertile and ready to become a genetically healthy baby.

In these cases, PGS (preimplantation genetic screening) is used to select only most developed and genetically heathy embryos. 
In the iVF Riga clinic, we are making thrombophilia and PAI genetic tests for women; based on these results it is possible to avoid early miscarriages for those who have problems with normal blood circulation.
 
The amount of follicles is a great gift for each woman from the time we came in this world for the first time, and how we are using this gift in our further life - is our own choice.

Unfortunately, some women receive menopause even in earlier age – it is called premature ovarian failure. In these cases, women produce the eggs that have diminished capability to fertilize and develop normally. Also, the ovaries and therefore the eggs could be damaged by cancer, cancer chemotherapy, radiation, severe pelvic infections, in rarely cases women have been born without one or even both ovaries.
 
Thanks to technological development in medicine, young women have a possibility to insure themselves, as they can freeze and storage their genetic material for the future use.

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Jelena Silkalna
Jelena Silkalna
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