LOW STOCK OF EGGS: HOW TO DEAL WITH IT?

The frustration of trying to conceive when it just does not happen can range from deeply disheartening to overwhelming. You are not sure what is going on, but you know there must be some reason why you cannot conceive. If you have been actively trying to conceive for a year (six months if you are over 35) without success, it is time to see a fertility specialist and find out why you are simply not getting pregnant.

There are all sorts of reasons for infertility, and your diagnosis points to the type of treatment you need. Some women face a condition called low egg reserve, or diminished ovarian reserve. This condition occurs when your ovaries produce very few eggs, or eggs that are not viable for fertilisation. It significantly affects your chances of a healthy pregnancy.

What is low egg reserve?

A woman is born with all the eggs she will ever have (about one million!), and by puberty the reserve stands at about 300,000 eggs. During their reproductive years, women ovulate about 300 to 400 eggs. As women get older, the reserve of viable eggs starts to fall. This is why pregnancy becomes harder as you approach menopause. Of the women seeking fertility treatment, between 20%-50% are diagnosed with low egg reserve. Ageing reduces the number of eggs you have, but there are other factors that affect your egg reserve and your fertility. These are:

• Endometriosis
• Chemotherapy
• Radiotherapy
• Tubal disease
• Previous ovarian surgery
• Pelvic infection
• Autoimmune disorder
• Early menopause
• Certain genetic abnormalities
• Smoking
• Mumps
• Unexplained diminished ovarian reserve

Symptoms of low egg reserve

Usually, the first sign that you may have a low egg reserve is being unable to conceive. In some cases, though, there are other, somewhat vague symptoms, such as:

• Amenorrhoea (missing one or more periods not due to pregnancy)
• Menstrual cycles (shorter than 21 days)
• Heavy periods
• Miscarriage

If you have any of these symptoms and have not been able to conceive after 12 months of unprotected intercourse (six months if you are over 35), it is important to see a reproductive specialist.

How is the condition diagnosed?

If you have any of the symptoms above, combined with your age, your lifestyle and being unable to become pregnant after trying for six to 12 months, your doctor may suspect a low egg reserve. There are a few different ways to diagnose a low egg reserve. On or around day three of your menstrual cycle, your doctor takes a blood sample to measure your hormone levels, specifically follicle-stimulating hormone (FSH)/oestradiol and anti-Müllerian hormone (AMH). These hormones are essential for normal, healthy ovulation. Women with higher FSH and lower AMH than normal are very likely to have a low egg reserve. AMH reflects the number of eggs in the body. Your doctor assesses these hormone levels together with a transvaginal ultrasound to count the visible follicles before making an accurate diagnosis.

Treatment for low egg reserve

If your doctor finds that you have a low egg reserve, there is no need to despair. Treatment options are available, depending on the extent of your egg reserve.

For people with a borderline diminished egg reserve, conventional IVF offers the greatest success. Women who have had multiple unsuccessful IVF treatments because of a poor response, or women with a very low egg reserve, may benefit from a mini-IVF protocol.

Women with a very low egg reserve are excellent candidates for IVF with donor eggs. Donor eggs are healthy, usually from a younger woman. Donors are screened, and both the donor and the recipient remain anonymous. Some people use healthy donor eggs from a close friend or family member. Choosing to use healthy donor eggs increases the success of IVF for women with a low egg reserve.

What you can do

If you are worried about a low egg reserve, the best thing you can do is make sure you are as healthy as possible. Stop smoking and avoid alcohol and other unhealthy substances. Eat a balanced diet and maintain a healthy weight. Make sure you do some form of exercise approved by your doctor and take supplements approved by your doctor.

Although a diagnosis of low egg reserve is stressful in itself, find healthy ways to cope with your stress. Get out into nature, meditate, take yoga classes and consider discussing your diagnosis with a qualified therapist.

At the “Dr. Alexandros Traianos” Reproductive Medicine Centre, we understand the stress that comes with infertility, and we are here to help you find answers in this very personal situation. With state-of-the-art facilities and an experienced team of scientists specialising in Reproductive Medicine, our Centre is ready to help you grow your family.