Fertility Wellness Starter Package

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What is ovarian reserve?

When a baby girl is born, she has about 1 to 2 million follicles. When a young lady reaches puberty, she starts to ovulate. During each menstrual cycle, oocytes develop to maturity from within a follicle. Only one oocyte will become a mature egg and be ovulated from its follicle. This process repeats every reproductive cycle and lasts for 30 to 40 years. A woman ovulates only about 400 eggs during her lifetime.

The number of antral follicles decline with age since the pool of waiting follicles is gradually used up. By the age of 35, women begin to lose ovarian reserve drastically due to the decreasing quantity of egg-containing follicles. The follicles may become less sensitive to hormone stimulation and it could be harder for an egg to mature and ovulate. Therefore, a loss of ovarian reserve means that a woman’s fertility is declined.

What is Premature ovarian insufficiency ?

The natural age-related decline in fertility may affect women in different ways. For an individual, biological and chronological ovarian age are not always equivalent. Premature ovarian insufficiency (POI) is the partial or total loss of reproductive and hormonal function of ovaries before the age of 40 due to follicular dysfunction or early loss of egg. POl may cause infertility, irregular menstrual cycles, early menopause, worsening of menopausal symptoms, osteoporosis, etc. Improved health in later life does not offset POI, but an early diagnosis allows prompt and appropriate family planning, for example performing intrauterine insemination (IUI) to increase the chances of pregnancy.

How to evaluate ovarian reserve and ovary function?

Anti-Mullerian Hormone (AMH) blood tests can help assess each woman’s ovarian biological age. AMH is produced by granulosa cells of preantral and early-antral follicles. Low levels indicate declined ovarian reserve, whereas very high levels may be a sign of Polycystic Ovary Syndrome (PCOS).

Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) reveal ovarian function. During each menstrual cycle, follicles secrete estradiol that triggers a series of events that lead to a surge in LH. FSH helps stimulate the growth of eggs in the ovaries. FSH levels reach their highest just before an egg is released by the ovary. Excessive levels in FSH implies that the brain is boosting the poorly performing ovaries into action and chances of becoming pregnant may be lower than expected for your age.

Prolactin is mainly responsible for lactation and breast development. High prolactin levels can disrupt the normal production of estrogen and progesterone, leading to menstrual disorders and difficult pregnancy.

The Thyroid-Stimulating Hormone (TSH) test can detect subclinical thyroid dysfunction in women, which may not present noticeable symptoms in early stages. However, abnormal thyroid function can negatively impact pregnancy success rates and increase miscarriage risks.