• Rose Unwin

Let's discuss low ovarian reserve

“Ovarian reserve” simply refers to the number of eggs you have left. The best way to get a true measure of your ovarian reserve is to:

  • test your AMH levels

  • have an antral follicle scan

Time for a science lesson?

Ovaries are two of the most important glands in the female reproductive system. Most women are born with two ovaries – one located on each side of the pelvis. The ovaries are responsible for producing egg cells. The number of egg cells in your ovaries is called your ovarian reserve. I hope you're still with me!

What determines how many eggs you have?

The quantity of eggs any woman has largely depends on two main factors:

1 - The first factor is how many eggs you were born with. It may surprise you to learn that some women are born with 50x more eggs than other women - who said life was fair?

2- And the second factor is the rate at which the eggs in the ovaries are depleted each menstrual cycle.

Both of those factors are largely determined by your genetics (nature) and your environment (nurture). I see this is a BIG FAT POSITIVE because there are things we can do to positively influence our egg quality. We aren't totally powerless in this situation. If you're in your mid 30s onwards and possibly have a diminished ovarian reserve, it's more important than ever to have a very healthy lifestyle. My fertility health coaching works with women to achieve this.

Let's link this all back to your monthly cycle

Your eggs develop on a monthly basis within follicles located in the ovaries, with some reaching full maturity. The development of follicles takes place in the follicular stage of your menstrual cycle which is typically days 1 to 14 of your cycle if you have a 28 day cycle. In reality very few people have this textbook 28 day cycle: for example, I have a 31 day cycle and I ovulate on day 16/17 so my follicular phase runs from day 1 to day 16, and this is when my follicles will be developing.

The hormone FSH (follicle stimulating hormone) is released by the pituitary gland in your brain, it enters your bloodstream and travels down to your ovaries where it tells them to start developing some of the follicles. Hormones are essentially chemical messengers. Each month your body will 'recruit' a few select follicles to mature so that it's not using up all of our reserves in one month. And out of this select group of ripening follicles, only one will 'rupture' or burst, releasing an egg into your fallopian tube.

The body is a clever thing because it knows if you have a lower egg reserve, and consequently we will produce more FSH in a bid to develop healthy eggs each month. Your FSH level with slowly rise with age as your egg reserve reduces, and after menopause the FSH level will be very low indeed. If you have a blood hormone analysis done, it's assumed that if you have a healthy normal range FSH level for your age then you have a healthy egg reserve. On average, women lose approximately 1000 follicles with each menstrual cycles after puberty – but let's not focus on this as it sounds a bit depressing and as I mentioned earlier, there are things we can do.

This image is from a scan of an ovary and those large clear sacs are developing follicles.

If you'd like to chat about your fertility, feel free to ring me on 07791508061 to arrange a free 15 minute consultation.

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