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Poor ovarian response, also known as poor ovarian reserve or low ovarian reserve, refers to a condition in which the ovaries produce fewer eggs than expected. Additionally, the eggs produced may be of lower quality. This condition can affect a woman's fertility and make it more challenging to conceive. It is commonly abbreviated as POR. It poses a challenge to fertility treatments as the quality and quantity of eggs impact the chances of a successful pregnancy.
A comprehensive understanding of this issue will help you address POR properly. Let us explore its causes and treatment options for complete knowledge.
Synopsis
What Are the Causes of Poor Ovarian Response?
The most common risk factors related to poor ovarian response are discussed below.
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Advanced Age: As women age, the number and quality of eggs they produce tend to decline. This is a natural part of the ageing process. Women of 35 years or above are more likely to develop POR.
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Genetic Factors: Some women may be genetically predisposed to have a lower ovarian reserve. These inherited conditions include premature ovarian insufficiency (POI) or specific gene mutations.
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Previous Ovarian Surgery: Surgical procedures on the ovaries, such as ovarian cyst removal, can reduce the ovarian reserve. Scar tissue formation or ovarian tissue damage during these procedures may affect its normal function.
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Chemotherapy or Radiation Therapy: Cancer treatments can have a negative impact on ovarian function.
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Autoimmune Disorders: These are conditions when your immunity system mistakenly attacks ovarian tissues, causing POR.
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Smoking: Smoking has been linked to decreased ovarian reserve.
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Endometriosis: This condition can affect ovarian function and reduce the number of eggs.
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Lifestyle Factors: Poor diet, excessive exercise, and high levels of stress can contribute to poor ovarian response.
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Environmental Factors: Exposure to environmental toxins, pollutants, and certain chemicals may adversely affect your ovarian health.
An accurate assessment of your ovarian reserve can help you with proper treatment planning. This is why correct diagnosis plays a crucial role. Let us discuss the different diagnostic approaches taken by an expert medical professional in the following section.
How Is Poor Ovarian Response Diagnosed?
The diagnostic tests provide valuable insights into a woman's reproductive potential. It will guide fertility specialists in formulating personalised treatment strategies for you.
Testing Ovarian Reserve
It includes the assessment of Follicle-stimulating Hormone (FSH), Anti-Müllerian Hormone (AMH), and Antral Follicle Count (AFC). FSH levels are usually analysed on the 3rd day of your menstrual cycle. Elevated levels may indicate a compromised ovarian reserve and the potential for poor response during fertility treatments. Lower levels of AMH also indicate the same. AFC is determined with the help of an ultrasound, whose lower count may indicate abnormalities.
Baseline Ultrasound and Estradiol Levels
This test helps evaluate the size, structure, and number of antral follicles in ovaries. Elevated levels of estradiol may interfere with FSH assessment, impacting the diagnosis of POR.
Menstrual History and Ovulation Patterns
This offers additional insights into your ovarian functions. Irregularities may indicate underlying issues. The historical context aids in identifying the potential contributors of POR.
Your doctor will prescribe a suitable treatment option depending on your specific condition.
Treatment Approaches Related to Poor Ovarian Response
When a woman is experiencing poor ovarian response and is trying to conceive, she may face challenges in responding to fertility treatments, such as in vitro fertilisation (IVF). Fertility specialists often tailor treatment plans based on the specific circumstances of each individual.
Treatment options for poor ovarian response may include:
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Ovarian Stimulation Protocols: Adjustments to the medication protocols used in fertility treatments. It may consist of oral medications, like Clomiphene Citrate or Letrozole. They usually help in hormonal regulation.
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Use of Gonadotropins: These are hormonal medications that stimulate the ovaries that can be administered through injections to enhance follicular development. This treatment approach needs regular monitoring of your hormone levels for timely adjustments.
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In Vitro Fertilisation (IVF): Specific IVF stimulation protocols are designed to optimise the recruitment and maturation of eggs. These involve higher doses of gonadotropins and individualised adjustments based on the patient's response. Following successful stimulation, mature eggs are retrieved from the ovaries using a minor surgical procedure. These eggs are then fertilised with sperm in the laboratory to initiate embryo formation. In the final stage of IVF, doctors transfer the developed embryos into your uterus.
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Intracytoplasmic Sperm Injection (ICSI): A procedure where doctors directly inject a sperm into an egg.
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Donor Eggs: In cases where the woman's eggs are not viable, using eggs from a donor may be considered.
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Ovarian Rejuvenation Techniques: They are used to improve ovarian function and enhance egg quality. While the process is still under research, some experimental approaches involve using Platelet-Rich Plasma (PRP) or stem cell therapies to stimulate the ovaries. They may help promote tissue repair and potentially rejuvenate ovarian function.
It's important for individuals facing poor ovarian response to consult with a specialist who can assess their specific situation. They recommend appropriate treatment options based on your age, overall health, and the cause of the poor ovarian response.
Consult a reproductive medicine hospital in Bangalore if you need poor ovarian reserve treatment.
Preventive Measures for Poor Ovarian Response
Optimising lifestyle and dietary factors are major precautionary methods to support your ovarian health. These measures usually include:
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Maintaining a balanced diet which is rich in antioxidants, vitamins, and minerals.
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Effective stress management for hormonal regulation.
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Minimising exposure to environmental toxins.
Along with the treatment, consider these preventive measures for the most effective result. Consult the best reproductive medicine doctor at Manipal Hospitals, Mysore, to address any concern related to POR or if you are experiencing poor ovarian reserve symptoms.
FAQ's
Yes, certain lifestyle modifications, especially your diet and stress management, can improve your ovarian response.
Advanced age is the most common factor for developing POR. However, there are other risk factors, too, like genetic disorders, environmental effects, etc.
Yes, the suitable treatment method depends on your condition. Other than medications, some treatment options are IVF, donor eggs, etc.
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