The reality of the female body is that the number of eggs in our ovaries peaks before we are even born. We have no control over this. A common misconception is that being on a birth control pill, which prevents ovulation, will maintain the ovarian reserve – unfortunately that’s not the case. To the best of my knowledge there is nothing a woman can do to prevent or reduce egg loss. It’s just what our bodies do. Additionally, although the average rate of egg decline tends to increase as women reach 37, every woman is different. I have seen ovarian reserves in young women that seem more consistent with that of a 40 year-old, and conversely I have seen women in their late 30s and early 40s whose ovaries behave likely they’re 20.
So what’s the significance of the ovarian reserve? I find that it is most useful in two ways: (1) predicting how the ovaries will respond to fertility drugs and (2) deciding how aggressive to be with treatment. Ovarian reserve does not predict likelihood of pregnancy, nor does it accurately determine when a woman will go through menopause. I explain to my patients that egg quality is more important than quantity. Sure, a woman with a good ovarian reserve will likely have an easier time responding to fertility drugs – perhaps making it more likely that we’ll obtain more good quality eggs – but a better ovarian reserve does not mean better egg quality. A young woman with a poor reserve is still more likely to have better quality eggs than an older reproductive aged woman with a good reserve.
Bottom line – ovarian reserve is important, but it is not the sole determinant of the outcome of fertility treatment and the likelihood of pregnancy. Don’t get caught up on numbers!
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