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Understanding Diminished Ovarian Reserve: Causes and Treatments
What is diminished ovarian reserve?
Ovarian reserve, the reproductive potential contned within a woman's ovaries based on egg count and quality, may experience loss due to decreased number or quality of remning eggs. This condition, referred to as diminished ovarian reserve DOR, results from normal aging but can also be caused by genetic disorders like Fragile X syndrome and other abnormalities affecting the X chromosome, aggressive medical treatments for cancer that damage reproductive systems, surgeries for conditions such as ometriosis, injuries, or simply lack of a discernible cause.
Aging is typically the mn driver behind DOR, which affects fertility by lowering the chances of conceiving naturally. Women with diminished ovarian reserve also face an increased risk of miscarriage when trying to conceive through in vitro fertilization IVF due to lower egg quality. The biological clock of women can vary significantly; some continue to be fertile into their 40s while others lose fertility in their 20s.
It's worth noting that, at birth, a woman has approximately two million eggs, decreasing to about 400,000 by puberty, around 27,000 by the late 30s, and roughly 1,000 when menopause begins. This gradual loss of ovarian reserve precedes the of menstruation.
Diminished Ovarian Reserve: A Brief Overview
Diminished ovarian reserve signifies a decline in reproductive potential within the ovaries due to reduced egg count or quality.
Ovarian reserve encompasses the quantity and quality of eggs, with diminished ovarian reserve indicating these factors are decreasing over time.
While DOR often becomes apparent around menopause, individual rates can vary significantly among women.
Aging is the leading cause of DOR, but this condition can also be attributed to genetic anomalies, aggressive treatments for cancer, or injuries like ometriosis. Physicians employ hormone tests and transvaginal ultrasound imaging to evaluate a woman's ovarian reserve.
There's no treatment that can halt of diminished ovarian reserve. However, women who are infertile due to low egg count or quality might utilize assisted reproductive technologies to achieve pregnancy.
Causes of Diminished Ovarian Reserve
The primary causes of DOR include:
Cigarette smoking
Genetic abnormalities such as Fragile X syndrome and other X chromosome issues
Intense treatments for cancer radiation therapy
Ovarian surgery related to conditions like ometriosis or injury
Idiopathic cases where there's no clear cause
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Diagnosing DOR
Diminished ovarian reserve often doesn't present any symptoms; the diagnosis usually occurs through diagnostic tests. These include transvaginal ultrasound and evaluations of follicle stimulating hormone FSH, estradiol a type of estrogen, and anti-Mullerian hormone AMH.
FSH and estradiol are indicators of fertility as well as a woman's response to ovulation induction or stimulation, which can d in conception. AMH typically correlates with fertility potential by reflecting the number of eggs left in the body.
Combined with transvaginal ultrasound findings, these tests help diagnose DOR accurately.
Fertility Treatment Options for Women with Diminished Ovarian Reserve
There's no cure to stop ovarian aging or prevent DOR effectively. However, women who still wish to conceive can opt for assisted reproductive technologies as follows:
Egg Donor Program: Using donated eggs in conjunction with in vitro fertilization IVF often provides the best option for women with low ovarian reserve, especially if their remning eggs are of poor quality.
Egg Donation: A woman can achieve pregnancy using the donor's eggs along with her partner's sperm or donated sperm to create an embryo that is then implanted into her uterus. Although this child doesn't share the birth mother's genes, she still gets to carry the baby through gestation and delivery.
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