Reduced Ovarian Function: Signs, Remedies, In Vitro Fertilization, and Additional Insights
In the realm of reproductive health, diminished ovarian reserve (DOR) can pose challenges for women seeking to conceive. This condition, characterised by a reduction in the quality and quantity of eggs, can be addressed through a combination of medical interventions, assistive reproductive technologies (ART), complementary therapies, and lifestyle changes.
To determine the number of eggs a woman has, a doctor may carry out an ovarian reserve test. This typically involves a transvaginal ultrasound and hormone level tests such as follicle-stimulating hormone, estradiol, and anti-Muellerian hormone.
Assistive Reproductive Technologies (ART) play a significant role in helping individuals with DOR conceive. In vitro fertilization (IVF) is the primary ART used, which bypasses many natural fertility barriers associated with low ovarian reserve. Egg freezing is another option, allowing preservation of eggs at a younger age before further decline occurs. Use of fertility medications such as clomiphene citrate and letrozole can stimulate ovulation and improve ovarian function, though their effectiveness may be limited in severe DOR cases.
Emerging regenerative therapies offer promising prospects. Ovarian PRP (Platelet-Rich Plasma) therapy involves injecting platelet-rich plasma derived from the patient’s own blood into the ovaries, potentially improving egg quality and quantity. Ovarian and uterine cavity rejuvenation therapies using autologous blood components are also offered at some specialized centres to enhance ovarian function, egg quality, and uterine lining for better IVF outcomes.
Complementary and supportive treatments such as acupuncture and nutritional supplements can also support reproductive function. Acupuncture has been documented to regulate hormonal balance, improve ovarian function, reduce apoptosis (cell death) in ovarian cells, and possibly enhance clinical pregnancy and live birth rates. Supplements recommended by fertility experts include antioxidants (e.g., CoQ10), NAD+ boosters, omega-3 fatty acids, and anti-inflammatory diets, which may improve egg quality and ovarian environment, particularly when combined with IVF.
Folic acid, DHEA, and vitamin D are important supplements, with folic acid minimizing the risk of neural tube defects, DHEA supporting the baby's development, and vitamin D benefiting both fertility and pregnancy. However, it's crucial to remember that supplemental DHEA may have side effects and risks.
It's essential to note that a female with DOR may not exhibit any symptoms until they try to get pregnant. If symptoms do occur, they may include a shortening of the menstrual cycle. Diminished ovarian reserve can have no clear cause and can be linked to genetics, smoking tobacco, genetic variants like fragile X syndrome, aggressive medical treatments such as radiation therapy for cancer, ovarian surgery for conditions like endometriosis, and other factors.
Fertility preservation, ovarian superovulation, IVF with donor eggs, and IVF with donor sperm are options to increase chances of pregnancy for those with DOR. Ovarian superovulation uses medications to induce the growth of multiple eggs, with doctors triggering ovulation and delivering sperm via intrauterine insemination. IVF with donor eggs involves using donor eggs to combine with sperm to create embryos for a person with a low ovarian reserve who may not be able to produce their own eggs or have low egg quality.
In conclusion, treatment for DOR typically involves a combination of ART (like IVF), fertility medications, and possibly emerging therapies like ovarian PRP, complemented by acupuncture and nutritional supplements aimed at enhancing ovarian function and egg quality. Individual responses vary, and close consultation with fertility specialists is essential to tailor treatment plans effectively.
- In cases of diminished ovarian reserve (DOR), health professionals may administer an ovarian reserve test that includes transvaginal ultrasound and hormone level tests like follicle-stimulating hormone, estradiol, and anti-Muellerian hormone.
- Science and medical advancements have opened doors for various therapies-and-treatments to address DOR, such as ovarian PRP therapy and ovarian cavity rejuvenation therapies offered at some specialized centres, which aim to improve egg quality and quantity.
- Complementary and supportive treatments, like acupuncture and nutritional supplements, can support women's health and reproductive function, potentially enhancing clinical pregnancy and live birth rates through hormonal balance, improved ovarian function, and a better ovarian environment.
- Medicare may be involved in covering treatments for women with DOR, such as ovarian superovulation, IVF with donor eggs, and IVF with donor sperm, which aim to increase pregnant chances for those with diminished ovarian reserve.
