4 Steps to Get Pregnant with Low Ovarian Reserve

by | Jul 16, 2023 | Fertility

What is a Low Ovarian Reserve?

Low ovarian reserve, also known as diminished ovarian reserve (DOR), occurs when a woman’s ovaries contain fewer eggs than expected for her age. This condition may be disheartening for those who long for a child, as it can make conception more challenging. While low ovarian reserve is often associated with older women, it can affect women of any age. The main indicator of low ovarian reserve is a reduced level of anti-Müllerian hormone (AMH) in the blood, which helps evaluate the number of eggs remaining in the ovaries.  

How Many Eggs Needed to Get Pregnant?

For women with a normal ovarian reserve, the average number of eggs retrieved during an IVF (In Vitro Fertilization) cycle ranges from 8 to 15. However, in cases of low ovarian reserve, the number of eggs retrieved may be significantly lower. It’s important to note that the quality of the eggs is equally crucial as the quantity, as low ovarian reserve can also impact egg quality. The number of eggs required for pregnancy varies depending on various factors, including the woman’s age, overall health, and specific circumstances. While it only takes one egg and one sperm to create a baby, the chances of success increase with a higher number of eggs available for fertilization.  

What is Ovarian Reserve by Age?

A woman’s ovarian reserve gradually declines with age. During a woman’s reproductive years, the number of eggs diminishes naturally, ultimately leading to menopause. Here is a breakdown of the ovarian reserve by age:

  1. In the 20s and early 30s: Women generally have a higher number of eggs and a better chance of achieving pregnancy. However, it’s important to remember that fertility can still vary from person to person.
  2. In the late 30s: The ovarian reserve starts to decline more rapidly, and the quality of the remaining eggs may diminish. This is why fertility specialists often recommend seeking medical advice if pregnancy is desired during this stage.
  3. In the 40s: By this stage, the number and quality of eggs have significantly decreased, making it more challenging to conceive naturally. Assisted reproductive technologies, such as IVF, may be recommended for women in their 40s who wish to become pregnant.

 

Diminished Ovarian Reserve and AMH

One important marker used to assess ovarian reserve is the anti-Müllerian hormone (AMH). AMH is produced by the follicles in the ovaries and is often measured through a blood test. A lower AMH level indicates a diminished ovarian reserve. While AMH levels are an essential tool in evaluating ovarian reserve, it’s crucial to remember that they are just one piece of the puzzle. Other factors, such as a woman’s age and overall health, also play a significant role in determining her fertility potential.

Can I Get Pregnant with Low Egg Count/Low Ovarian Reserve?

Yes, you can get pregnant with a low egg count. While a low egg count or diminished ovarian reserve can pose challenges, it doesn’t mean that pregnancy is impossible. Women with a low ovarian reserve may face a decreased likelihood of natural conception, and the chances of success with fertility treatments, such as in vitro fertilization (IVF), may be lower compared to women with normal ovarian reserve. However, every woman is different, and it’s important to consult with a fertility specialist to assess your individual situation and explore available options.  

4 Steps to Get Pregnant with Low Ovarian Reserve/Low Egg Count?

  1. Consult with a Fertility Specialist: The first step is to seek guidance from a fertility specialist who can assess your specific situation and provide personalized recommendations. They will evaluate your ovarian reserve and suggest suitable treatment options tailored to your needs.
  1. Optimize Your Lifestyle: Making certain lifestyle adjustments can enhance your chances of conceiving. Here are some key tips:
  • Healthy Diet: Maintain a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. Avoid processed foods and incorporate fertility-boosting nutrients such as folic acid, iron, and omega-3 fatty acids.
  • Regular Exercise: Engage in moderate physical activity regularly to improve blood circulation and overall health. Consult with your doctor before starting any exercise regimen.
  • Stress Management: Practice stress-reducing techniques like meditation, yoga, or deep breathing exercises to promote relaxation and hormonal balance.
  1. Consider Fertility Treatments: Various fertility treatments can assist in increasing your chances of conception. Some options to discuss with your fertility specialist include:
  • In Vitro Fertilization (IVF): IVF involves stimulating your ovaries to produce multiple eggs, which are then retrieved and fertilized with sperm in a laboratory. The resulting embryos are transferred to your uterus.
  • Intrauterine Insemination (IUI): IUI involves placing sperm directly into your uterus during your ovulation period, maximizing the chances of fertilization.
  • Egg or Embryo Donation: If your ovarian reserve is extremely low, you may consider using donor eggs or embryos from a third party.
  1. Explore Alternative Therapies: Several alternative therapies may complement conventional treatments and potentially improve fertility outcomes. These may include:
  • Acupuncture: This ancient practice may enhance blood flow to the reproductive organs and help regulate hormonal balance.
  • Herbal Supplements: Some herbs like chasteberry, maca root, and raspberry leaf have been traditionally used to support reproductive health. However, consult with your doctor before taking any supplements.

 

What Are the Symptoms of Low Ovarian Reserve?

Detecting low ovarian reserve can be challenging, as there are often no obvious symptoms. However, some signs may indicate a potential issue with ovarian reserve. These include:

  1. Irregular Menstrual Cycles: If you experience irregular periods, it could be a signal of low ovarian reserve. Changes in the length and consistency of your menstrual cycles may indicate a decline in the quantity and quality of your eggs.
  2. Difficulty Conceiving: Struggling to get pregnant despite regular unprotected intercourse can be a sign of low ovarian reserve. If you’ve been actively trying to conceive for a year without success (or six months if you’re over 35), it may be time to consult a fertility specialist.
  3. Early Menopause: If you experience early menopause, characterized by the cessation of menstrual periods before the age of 40, it could be an indication of low ovarian reserve. Early menopause suggests that the ovaries are no longer functioning optimally, resulting in a diminished egg supply.

 

What Causes Low Ovarian Reserve?

Understanding the causes of low ovarian reserve is essential in unraveling this complex condition. While the exact cause may vary from woman to woman, several factors can contribute to diminished ovarian reserve. These include:

  1. Age: Age is the most significant factor affecting ovarian reserve. As women age with time, the number and quality of their eggs naturally decrease. By the age of 35, a woman’s fertility starts to decline, and after 40, the decline accelerates. Therefore, advancing age is a common cause of low ovarian reserve.
  2. Genetic Factors: Genetic factors can also play a role in ovarian reserve. Some women may be born with fewer eggs than average or have genetic conditions that accelerate the depletion of their eggs. Inherited conditions like Turner syndrome and Fragile X syndrome can impact ovarian reserve.
  3. Medical Treatments: Certain medical treatments, such as radiation therapy and chemotherapy for cancer, can have a detrimental effect on ovarian function and deplete the ovarian reserve. Additionally, surgeries involving the removal of the ovaries or ovarian cysts can impact ovarian reserve.
  4. Lifestyle Factors: Although less pronounced than age or genetic factors, certain lifestyle choices can influence ovarian reserve. Smoking, excessive alcohol consumption, and being significantly underweight or overweight can potentially impact fertility and ovarian reserve.

 

What are the Screening Tests For Low Ovarian Reserve?

When it comes to assessing ovarian reserve, there are several screening tests that can provide valuable insights. Here are a few commonly used screening tests:

  1. Day 3 Follicle-Stimulating Hormone (FSH) Test: The Day 3 FSH test measures the level of follicle-stimulating hormone in the blood on the third day of the menstrual cycle. Elevated FSH levels indicate a decline in ovarian reserve.
  2. Anti-Müllerian Hormone (AMH) Test: The AMH test measures the level of anti-Müllerian hormone, which reflects the number of follicles present in the ovaries. A lower AMH level suggests a diminished ovarian reserve.
  3. Antral Follicle Count (AFC): The AFC test involves an ultrasound examination to count the number of small follicles present in the ovaries. A lower AFC may indicate low ovarian reserve.

 

What are the Treatment Options for Diminished Ovarian Reserve?

While low ovarian reserve can present challenges, there are treatment options available to improve the chances of conception. Here are a few common approaches:

  1. Ovarian Stimulation: Ovarian stimulation involves the use of fertility medications to stimulate the ovaries and increase the number of mature eggs produced during a menstrual cycle. This can improve the chances of successful conception, especially in conjunction with assisted reproductive techniques such as in vitro fertilization (IVF).
  2. Egg Donation: For women with severely diminished ovarian reserve, egg donation can be a viable option. This involves using donor eggs from a young, healthy woman, which are fertilized with the partner’s or donor’s sperm and transferred to the recipient’s uterus.
  3. Fertility Preservation: For women who are not yet ready to conceive but are concerned about their ovarian reserve, fertility preservation techniques such as egg freezing can be considered. This allows women to preserve their eggs at a younger age for future use.

 

What is the Best IVF Protocol for Low Ovarian Reserve?

In vitro fertilization (IVF) is a common fertility treatment for women with low ovarian reserve. However, there isn’t a one-size-fits-all IVF protocol for every woman. The best IVF protocol for low ovarian reserve depends on various factors and should be tailored to each individual’s specific situation. Here are a few protocols that may be considered:

  1. Agonist/Antagonist Conversion Protocol: This protocol involves initially suppressing the ovaries with medications called GnRH agonists or antagonists. Once suppression is achieved, ovarian stimulation begins to promote the development of multiple follicles. This protocol aims to maximize the number of eggs retrieved during the IVF cycle.
  2. Mini-IVF Protocol: The mini-IVF protocol is a milder approach to ovarian stimulation, using lower doses of fertility medications. This protocol focuses on the quality of the eggs rather than the quantity, aiming for a smaller number of high-quality eggs.
  3. Natural Cycle IVF: Natural cycle IVF involves monitoring the natural menstrual cycle without the use of fertility medications. Instead of stimulating multiple follicles, only the naturally selected dominant follicle is retrieved and fertilized. This protocol is suitable for women who have very low ovarian reserve or prefer a more natural approach.

 

Success Rate of IVF with Low Ovarian Reserve:

IVF can be a viable option for women with low ovarian reserve who desire to conceive. However, it’s essential to manage expectations as the success rate may be lower compared to women with normal ovarian reserve. Several factors influence the success rate, including age, the cause of low ovarian reserve, and overall reproductive health. It’s crucial to consult with a fertility specialist who can assess your specific situation and provide personalized guidance. While IVF success rates can vary, advancements in technology and individualized treatment approaches offer hope to women with low ovarian reserve.  

Does Low Egg Count Mean Early Menopause?

The connection between low egg count and early menopause is a valid concern for women with low ovarian reserve. While low egg count is an indication of diminished ovarian reserve, it does not necessarily mean early menopause. Early menopause refers to the cessation of menstrual periods before the age of 40. It can be caused by various factors, including genetic predisposition, medical treatments, or autoimmune disorders. While low ovarian reserve can increase the risk of early menopause, it is not a definitive predictor. It’s important to consult with a healthcare professional to evaluate your specific situation and discuss potential implications.  

How to Improve Ovarian Reserve?

While ovarian reserve naturally declines with age, there are strategies to optimize and improve ovarian reserve. Although these approaches cannot completely reverse low ovarian reserve, they may positively impact fertility potential. Here are some methods to consider:

  1. Lifestyle Changes: Making healthy lifestyle choices can have a positive impact on ovarian reserve. Maintaining a balanced diet, regular exercise, reducing stress levels, and avoiding smoking and excessive alcohol consumption can contribute to overall reproductive health.
  2. Fertility Supplements: Certain fertility supplements, such as DHEA (Dehydroepiandrosterone), CoQ10 (Coenzyme Q10), and myoinositol, have been suggested to improve ovarian function and egg quality.
  3. Ovarian Stimulation: In certain cases, fertility treatments involving ovarian stimulation may help improve ovarian reserve. Ovarian stimulation aims to increase the number of mature eggs available for fertilization during an IVF cycle. This approach can be tailored to each individual’s needs and may enhance the chances of successful conception.

 

Conclusion

Getting pregnant with low ovarian reserve or a low egg count can present challenges, but it is not impossible. While it may require additional effort and intervention, there are options available for couples facing this situation. Seeking the guidance of a reproductive specialist is crucial, as they can provide personalized advice and recommend the most suitable fertility treatments. Techniques such as in vitro fertilization (IVF) with donor eggs or embryos, egg freezing, and fertility medications can help overcome low ovarian reserve and increase the chances of conception. Additionally, adopting a healthy lifestyle, managing stress, and optimizing overall well-being can positively impact fertility.

F.A.Q

Q: How can I get pregnant fast with a low egg count?

A: When facing a low egg count, getting pregnant quickly can be challenging. It’s crucial to consult with a fertility specialist who can suggest appropriate treatments like fertility medications, in vitro fertilization (IVF), or intrauterine insemination (IUI). These methods aim to stimulate egg production, improve fertilization odds, and boost your chances of conceiving.

Q: What happens if the egg count is low?

A: If you have a low egg count, also known as diminished ovarian reserve, it means you have fewer eggs available for fertilization. This can lead to difficulties in getting pregnant naturally. With a reduced egg count, the likelihood of successful conception decreases, making it more challenging to achieve pregnancy without medical interventions or fertility treatments.

Q: Can you get pregnant naturally with a low follicle count?

A: Having a low follicle count can impact your ability to get pregnant naturally. Follicles are fluid-filled sacs in the ovaries that contain eggs. A low follicle count suggests a decreased number of eggs available for fertilization. While it may still be possible to conceive naturally with a low follicle count, the chances are significantly reduced. Seeking medical advice and exploring fertility treatments can provide more options for a successful pregnancy.

Q: What food increases egg count?

A: While specific foods cannot directly increase the number of eggs you have, maintaining a healthy diet can support overall reproductive health. Opt for a well-balanced diet that includes a variety of fruits, vegetables, whole grains, lean proteins, and healthy fats. Nutrient-rich foods like leafy greens, citrus fruits, nuts, and seeds can provide essential vitamins and minerals that support fertility.

Q: How many eggs do you lose per period?

A: During each menstrual cycle, only one egg is typically released for potential fertilization. The other eggs that were initially recruited and developed during that cycle naturally undergo a process of degeneration and are ultimately lost. This means that, on average, a woman loses just one egg per menstrual period.

Q: Why is my egg quality poor?

A: Several factors can contribute to poor egg quality. Advanced maternal age is a significant factor, as egg quality tends to decline with age. Other factors that can affect egg quality include certain medical conditions, lifestyle choices (such as smoking or excessive alcohol consumption), exposure to environmental toxins, and underlying genetic factors. Consulting with a fertility specialist can help identify potential causes and explore treatment options.

Q: Why is my egg reserve so low?

A: A low egg reserve, also known as diminished ovarian reserve, can be influenced by various factors. Advanced maternal age is a primary contributor, as a woman’s egg reserve naturally diminishes over time. Other factors that can lead to a low egg reserve include certain medical conditions, previous surgeries involving the ovaries, exposure to radiation or chemotherapy, and genetic predisposition. It’s advisable to consult with a fertility specialist to evaluate your specific situation and explore potential treatment options.

Q: What is a good egg count for a woman?

A: The number of eggs a woman has can vary widely depending on various factors, including age. Typically, a woman is born with a fixed number of eggs, and this number gradually declines over time. While the average egg count is around 1-2 million at birth, it decreases to approximately 300,000-500,000 by the time of puberty. By the age of 37, the egg count drops to about 25,000. It’s important to note that the quality of the eggs also diminishes as a woman ages. Assessing egg count and quality through medical evaluations with a fertility specialist can provide a clearer understanding of your individual fertility potential.

Q: Is it possible to increase the egg count?

A: Unfortunately, it is not possible to increase the number of eggs you have. Women are born with a finite number of eggs, and this supply gradually diminishes over time. While there are no known methods to increase egg count, certain fertility treatments, such as ovarian stimulation, can help maximize the use of the existing eggs.

Q: Can I get pregnant naturally with 2 follicles?

A: Having 2 follicles can increase the chances of getting pregnant naturally, as it means there are two potential eggs available for fertilization. However, it’s important to note that the presence of multiple follicles does not guarantee pregnancy, as successful conception depends on various factors such as sperm quality, timing of ovulation, and overall reproductive health.

Q: Can stress cause low follicle count?

A: Chronic stress can have an impact on reproductive health, but it is unlikely to directly cause a low follicle count. Stress can disrupt hormonal balance and interfere with the normal functioning of the reproductive system, potentially affecting ovulation and menstrual cycles. While stress may indirectly contribute to fertility challenges, the exact relationship between stress and follicle count is not well-established.

Q: How can I improve my egg quality to conceive?

A: Improving egg quality is a complex process, but certain lifestyle changes can support overall reproductive health. Maintaining a balanced diet, exercising regularly, managing stress, and avoiding smoking and excessive alcohol consumption can all contribute to better egg quality. Additionally, specific fertility treatments like preimplantation genetic testing (PGT) can help identify and select embryos with higher chances of successful implantation.

Q: Can fasting improve egg quality?

A: There is limited scientific evidence suggesting that certain forms of fasting, such as intermittent fasting, may have potential health benefits. However, the direct impact of fasting on egg quality is not well-established. It’s essential to maintain a well-balanced diet and consult with a healthcare professional before making any significant changes to your eating patterns, especially when trying to conceive.

Q: How can I increase my egg chances?

A: While it’s not possible to increase the number of eggs or change their quality, several factors can enhance your chances of conception. Monitoring your menstrual cycle and timing intercourse appropriately, maintaining a healthy lifestyle, managing stress, and seeking medical advice from a fertility specialist can all help optimize your chances of getting pregnant.

Q: Can a woman’s low egg quality be improved?

A: The quality of a woman’s eggs naturally declines with age and cannot be improved through medical interventions. However, certain lifestyle changes, such as adopting a healthy diet, managing stress, and avoiding harmful habits like smoking and excessive alcohol consumption, can potentially minimize further damage and support overall reproductive health. Fertility treatments, such as IVF with donor eggs, may also be considered if low egg quality is a significant concern. Consulting with a fertility specialist is crucial to explore the best options for your individual circumstances.

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    Dr Mona Dahiya

    Dr Mona Dahiya

    IVF Specialist & Consultant

    Dr Mona Dahiya has performed over 5,000+ IVF cycles and is considered a global expert in IVF, ICSI, IUI and male fertility treatment. She is an eminent writer on Infertility Treatment and has over 100 Publications in both International and National Journals. Dr Mona Dahiya has immensely contributed to the field of infertility through her Research and articles.

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