OVARIAN RESERVE

OVARIAN RESERVE OR REPRODUCTIVE POTENTIAL also known as the quality and quantity of eggs in a female – women’s ability to conceive a healthy pregnancy.

Egg quantity

The concept of reproductive aging is based on the principle that eggs peak in number during fetal life, undergo degeneration, and do not regenerate. Remarkably, the most eggs woman will have are when she is a 20-week-old fetus with approximately 6-7 million eggs. At birth, the number of eggs falls to 1-2 million, and at puberty, she has only 300,000-500,000 remaining eggs. From puberty through menopause, it is estimated women will ovulate about 400-500 total eggs. After menopause, the no. of eggs is very low with almost nil ovulation. The quantity of eggs can’t be changed in a woman.

Egg quality describes an egg’s genetic normality or abnormality. A chromosomal normal egg has 23 chromosomes when fertilized by a healthy sperm, which also has 23 chromosomes the resulting chromosomally normal embryo will have a total of 46 chromosomes. At the age of 30, 70% of a woman’s eggs are chromosomally normal. At 35 years of age, about 60% of a woman’s eggs are chromosomally normal (Euploid). By the time a woman reaches 40, about 35% of her eggs are chromosomally normal. As a woman’s ovary ages, she will have increasing numbers of chromosomally abnormal (aneuploid) eggs that contain too few or too many chromosomes. If conception occurs with an aneuploid egg, the embryo will inherit too few or too many chromosomes. Most aneuploid embryos will either fail to implant in the uterus or will result in miscarriage. In some instances, the aneuploid embryos may result in chromosomal disorders, such as Down syndrome, extra copy of chromosome 21.

How to improve ovarian reserve

Even though the number of eggs cannot be increased, it is possible to improve the quality of the eggs for better chances of conception. Here are a few tips that you can follow to improve the quality of eggs when trying to get pregnant.

  1. Maintain a healthy sleep cycle

Proper rest is essential for the body to heal and to function at a full metabolic level while awake. It is recommended to get at least 7 to 8 hours of sleep daily.

  1. Stress Management

Hormones like Prolactin and Cortisol are triggered due to stress. These hormones interfere with the ovulation process. Stress-relieving methods such as meditation, yoga, exercise, or any hobby that might help you release the built-up tension can help.

  1. Boosting blood flow to the ovaries

Oxygen-rich blood nourishes the ovaries to maintain good egg health. Regular yoga and exercise can help in boosting the blood flow.

  1. Weight loss

Maintaining a balanced weight is vital for your reproductive health. Being overweight can lead to hormonal imbalances, which can, in turn, affect ovulation. Aim for a Body Mass Index (BMI) from 18.5 to 24.9. To give you a reference, if you’re 5 feet 6 inches tall, you should weigh between 52 kg and 70 kg. A healthy diet and regular exercise blend can help you hit your target.

  1. Eat healthy

Making healthy food choices not only improves reproductive health but also contributes to improving overall health.

  • Complex carbohydrates, including whole grains like brown rice, oats, and wholemeal bread
  • Plenty of fruit and vegetables daily
  • Organic foods
  • Oil-rich foods like fish, nuts, seeds and olive oil
  • Avoiding trans fats
  • Increase intake of fibre
  • More fish and organic eggs than red meat
  • Steer clear of additives, preservatives, and chemicals such as artificial sweeteners
  • Reduce or avoid sugar, both on its own and that which is hidden in food
  • Reduce or eliminate caffeine, e.g. coffee, colas
  • Eliminate processed foods as much as possible.
  1. Prevention
    Avoid alcohol and smoking and highly processed carb foods.
  2. Supplementation

Supplementation of folic acid vitamin D Omega3 fatty acids and anti oxidants

  • Folic Acid:This is a vital vitamin for those planning a pregnancy. It’s recommended not only when you’re trying to conceive but also during pregnancy.
  • Vitamin D: If you’re on the path to parenthood, make sure that you get adequate Vitamin D to maintain your levels between 40 and 50 units. Omega-3 Fatty Acids: A daily intake of 600 mg to 100 mg of Omega-3 will help. These fatty acids play a vital role in supporting fertility. Omega-3 fatty acids found in fish, chia seeds, and walnuts support egg membrane integrity and hormone balance, crucial for reproductive health. Berries (e.g., blueberries, strawberries), leafy greens (e.g., spinach, kale), and nuts (e.g., almonds) are excellent sources of antioxidants that protect eggs from damage

How to Check for Ovarian Reserve

Menstrual cycle length, Duration, and flow, and regularity

And by hormonal tests and ultrasound

One common way to test ovarian reserve is by measuring hormone blood levels. Follicle-stimulating hormone (FSH) and estradiol are checked at the beginning of the menstrual cycle. This is usually done on cycle day 3, but it can be drawn from day 1 to 5.

Anti-Mullerian hormone (AMH) is a vital test for checking ovarian reserve. It’s made in the follicles, which house the eggs, and its levels can be checked at any time during the menstrual cycle

The Clomiphene Citrate Challenge Test was used to predict how ovaries would respond to IVF cycles. It involved taking clomiphene citrate early in the menstrual cycle and measuring FSH and estradiol levels before and after.

A transvaginal ultrasound may be done in the early part of the menstrual cycle to count the number of small (2mm- 10mm) follicles in the ovary. These are called antral follicles and are where eggs develop. The number of antral follicles can tell us how many eggs are available and about the woman’s response to fertility medicines. The size of the ovaries and blood supply are also assessed on ultrasound.