Low Ovarian Reserve

Ovarian reserve refers to the number and quality of remaining eggs that a woman has in her ovaries. This contributes to the likelihood of being able to conceive. With age it is natural for the amount of eggs a woman has to decrease, although there are other factors that could have an impact. Here we discuss what a diminished or low ovarian reserve is, its symptoms, testing options and its importance when it comes to our fertility.

What is a low ovarian reserve?

This refers to the reproductive potential left within a woman’s two ovaries based on the number and quality of eggs. Low (or sometimes called diminished) ovarian reserve is the reduction in reproductive potential due to a number of the remaining eggs.

Women are born with a fixed number of follicles in their ovaries. These are gradually lost over her lifetime. This process occurs even during pregnancy or when a woman is on the contraceptive pill. The rate of loss of egg-containing follicles may vary from woman to woman and can be affected by external factors such as smoking that is known to accelerate this loss of follicles. 

What are the symptoms?

There aren’t many noticeable symptoms of diminished ovarian reserve. However, those with the condition might experience any of the following symptom:

  • Difficulty getting pregnant, reduced fertility
  • Late or absent menstrual periods
  • Shorter menstrual cycles than average, with the average being 28 days
  • Heavy menstrual flow

That said, these symptoms aren’t always present. This is why it’s important to talk to your doctor if you’re having difficulty conceiving, as they will be able to recommend fertility tests that are right for you.

What causes a low ovarian reserve?

Aging naturally reduces your egg reserves. However, a number of other factors can cause diminished ovarian reserve. These include:

  • Tubal disease
  • Endometriosis
  • Chemotherapy
  • Radiation therapy
  • Smoking
  • Pelvic infection
  • Autoimmune disorders
  • Mumps
  • Certain genetic conditions

How to test?

Loss of ovarian reserve is usually tested with blood tests of hormones such as follicle stimulating hormone (FSH), Anti-mullerian hormone (AMH) and an ultrasound for checking the antral follicle count (AFC) to give an assessment.