POOR OVARIAN RESPONSE
What is Ovarian Response or Poor Ovarian Reserve?
Ovarian reserve is a way to know the quantity and quality of eggs in the ovary. It is also an indicator of the procedure required for stimulation of ovary for maturation of eggs during IVF. This correlates with the response of the ovaries to medication to produce eggs, healthy embryos and a healthy live pregnancy.
What is the Meaning of Poor Ovarian Response?
The meaning of poor ovarian response indicates that the lady has a lower chance to conceive and produce normal, healthy child. Even if the patient is 20-30 years of age, with poor ovarian response indicates low chances of pregnancy in IVF treatment or natural conception. More often than not, patients with poor ovarian reserve show poor results in IVF treatment.
While There are Lots of Causes of Diminished Ovarian Reserve Which are unexplained, Some Common Causes are:
- Age is greater than 35.
- Cancer treatments with radiation and certain chemotherapy agents.
- Premature ovarian failure.
- Surgical removal of part or the whole of the ovary.
- Genetic abnormalities (Fragile X permutation or X chromosome abnormality).
Impact of Poor Ovarian Response
- Decrease chances of conceptions.
- Increase the chances of miscarriages
- Increase the chances of having an abnormal baby
Treatment for Poor Ovarian Response
These days it is not very uncommon, to come across patients with poor ovarian reserve and are unable to conceive. This, kind of diagnosis is very unsettling between the couple. It is not very easy for the female to accept, especially if she if she young.
There are several tests to determine ovarian reserve and the most reliable is blood AMH (Anti Mullerian Hormone). In addition disruption of the menstrual cycle, day 3 levels of FSH & estrogen are good indicators of the poor ovarian reserve. We generally categorize them as poor responders.
Depending on the levels of AMH, and ovarian antral follicle count the protocol for ovarian stimulation is modified to induce supra ovulation.
But the best course in such advanced cases is egg donation.