A woman is born carrying all of the eggs she will ever have, approximately one-two million. As she matures and enters puberty about one-third of the eggs remain. Unfertilized eggs collapse in the pelvis or the fallopian tubes each month and two weeks before the menstrual period begins. A fertilized egg implants 7 days after ovulation in the uterus and there it grows from embryo to fetus to baby.
Low egg reserve, often referred to as diminished ovarian reserve, is a condition characterized by a decrease in the number and viability of the eggs a woman has stored in her ovaries. It’s often associated with age and affects fertility and the ability to conceive. Between 10%-30% of women who aren’t able to become pregnant and seek out the help of a fertility specialist receive a diagnosis of diminished ovarian reserve.
Low egg reserve isn’t always related to age. Genetic defects, injury, endometriosis, some surgeries and aggressive treatment for certain cancers are also linked to diminished ovarian reserve. In many cases there is no apparent cause for a decrease in egg reserve.
Most women are unaware of diminished ovarian reserve until they try to conceive without success. For those dealing with a diagnosis of diminished reserve, it might feel hopeless, or at least pretty grim. While there is no treatment to prevent aging of the ovaries, there are procedures which can help boost your odds for conception. Here we look at some options.
Options for Low Egg Reserve
Every diagnosis of infertility is unique, and the circumstances surrounding treatment are individual as well. Depending on the degree of your diminished ovarian reserve, your doctor may suggest some different treatment options.
Ovarian stimulation uses hormone medication to increase the number of matured follicles/eggs your ovaries release. Your physician retrieves the eggs and uses them for in vitro fertilization (IVF), intra-uterine insemination (IUI) or freezes them for future use. The success rates for IVF and IUI depend on the number of healthy and viable eggs you produce.
IVF
Once your doctor retrieves your eggs and determines them to be healthy and viable the lab fertilizes the egg(s) using your partner’s sperm. Once fertilized the lab observes the process for embryo development. At about the 5th day, the lab tests the embryos, if you request, using a process known as preimplantation genetic testing (PGT). PGT rules out any chromosomal or genetic issues. Once the tests confirm your embryo(s) as healthy and viable (about 5-7 days) the doctor implants then into your uterus. If you opt not to have PGT, your doctor implants them sooner.
The success rates for IVF are very good for women even with diminished ovarian reserve.
ICSI
Using traditional IVF methods the lab takes 25,000-100,000 processed sperm to surround each egg and, hopefully, fertilization occurs. ICSI is another more accurate method for fertilization in which the lab injects the egg with a single sperm, using a microscope. This is a very successful method of IVF, especially when diminished ovarian reserve is complicated by a partner’s male factor infertility.
Third Party Donor Eggs
Sometimes it isn’t possible to retrieve heathy eggs using any of the assisted reproductive technologies. Advanced age, premature ovarian failure or recurrent failed cycles of IVF may prevent any possibility of a healthy pregnancy using your own biological egg. When this is the case egg donation offers the best opportunity for a healthy pregnancy.
In most cases your doctor retrieves donor eggs from an anonymous donor of your choosing, through an agency. You also have the option of using the eggs of a family member with a biological connection such as a sister or cousin. Sometimes patients opt to use eggs donated by a friend. Whatever the case your donor goes through medical and psychological screenings, family medical history and so forth. Some egg donation agencies may provide details such as education or physical characteristics.
There are many benefits to using an egg donor. Typically, especially through agencies, the donor is young and healthy and able to provide more eggs than are necessary for a single pregnancy. That means you can freeze embryos for future pregnancy. Another benefit is because the donor is young and healthy there is a much lower chance of chromosomal abnormalities. The risk of miscarriage as well as certain birth defects is lower as well.
After the doctor retrieves the donor eggs you proceed with IVF.
Find Your Best Path to Parenthood
If you’ve been trying to conceive for a year, or 6 months for women over 35, and haven’t had success you may suffer from a low egg reserve. For more information contact LA IVF. Our compassionate and caring team works with you to find the best path to realizing your dream of having a baby.
