The frustration that arises when you are attempting to conceive but are facing difficulties can be incredibly overwhelming. Despite your efforts, you find yourself unable to get pregnant, and you yearn to uncover the underlying cause.
If you have been actively trying to conceive for one year (or six months if you are over 35) without success, it is crucial to seek assistance from a fertility specialist who can help determine the reason behind your inability to conceive.
Vijaya Kumar, one of our patients wrote: “My wife had a slightly lower AMH value; Dr. Jagrati identified the issue at once, and within 4-5 months, with her hormonal therapy, my wife was able to conceive.”
It is essential to acknowledge that the journey of infertility can be emotionally taxing, leaving individuals feeling isolated and disheartened. The frustration, disappointment, and longing that accompany the inability to conceive naturally can be overwhelming.
However, it is crucial to remember that you are not alone in this experience. Countless individuals and couples have faced similar challenges and have sought the support of dedicated healthcare professionals, like Dr. Jagrati Laad to help navigate the path to parenthood.
Through this blog, we intend to provide valuable insights into the causes, diagnosis, and treatment options for low egg reserve and low AMH levels, empowering couples with knowledge on conceiving naturally after hormonal treatment and guiding them toward their journey to parenthood.
Infertility can stem from various factors, and the diagnosis you receive will guide the appropriate treatment. For some women, a condition known as low egg reserve or diminished ovarian reserve may be the cause.
What is a Low Egg Reserve?
Every female is born with a predetermined number of eggs—approximately one million. By the time puberty arrives, around 300,000 eggs remain in reserve. Throughout a woman’s reproductive years, she typically ovulates around 300 to 400 eggs. However, as women age, the quantity of viable eggs gradually decreases, making conception more challenging as menopause approaches.
This condition of low egg reserve or diminished ovarian reserve arises when the ovaries produce insufficient eggs or eggs that are not viable for fertilization. Such a diagnosis significantly impacts the chances of achieving a healthy pregnancy.
It is important to understand that this diagnosis does not define your journey but serves as a starting point to explore various options and treatments that can help you achieve your dream of having a child. There are various factors responsible for low egg reserves.
When individuals seek fertility treatment, it is estimated that 20% to 50% of them receive a diagnosis of low egg reserve. While aging is a natural factor that diminishes egg reserve and fertility, there are other factors that can impact it as well.
Factors Affecting Low Egg Reserve
Various factors contribute to low egg reserves, such as:
- Age: As women age, their reserve egg count and quality decline, leading to reduced fertility.
- Genetic Factors: Certain genetic conditions can affect ovarian function and diminish egg reserve.
- Medical Treatments: Previous surgeries, radiation therapy, or chemotherapy may impact ovarian health.
- Lifestyle Factors: Smoking, excessive alcohol consumption, and poor diet can influence egg reserve.
Symptoms of Low Egg Reserve
Usually, the initial indication of a low egg reserve is the difficulty in achieving pregnancy. However, there are instances where individuals may experience other relatively ambiguous symptoms, including:
- Amenorrhea/Irregular periods (absence of one or more periods not due to pregnancy)
- Menstrual Cycles shorter than 21 days
- Heavy Periods
- History of Miscarriage
- Early Menopause Signs: Premature symptoms such as hot flashes, mood swings, and vaginal dryness
Ideally, even after unprotected intercourse for a year, if you aren’t able to conceive, you should immediately consult a fertility doctor. As age increases, the chances of conceiving decrease. Hormones play a very important role in fertility and the production of eggs.
Role of Hormonal Imbalance on Female Fertility
Hormonal imbalances can significantly cause fertility issues and contribute to low egg reserves. These imbalances disrupt the delicate hormonal interplay necessary for ovulation and successful conception.
How is Hormonal Imbalance Diagnosed?
If you have concerns about low egg reserves or hormonal imbalances impacting your fertility, it is important to consult a fertility doctor.
At Wombs Fertility & Reproductive Health Clinic, Dr. Jagrati Laad will conduct a thorough assessment that involves obtaining a detailed medical history, performing a physical examination, and conducting specific diagnostic tests. This comprehensive evaluation allows the fertility expert to accurately diagnose the underlying causes of your condition.
There are a few different ways for your doctor to diagnose low egg reserves. On or about the third day of your menstrual cycle, your doctor does a blood test to measure your hormone levels, specifically the follicle-stimulating hormone (FSH) or estradiol and the anti-Müllerian Hormone (AMH) levels. These hormones are necessary for normal, healthy ovulation. A blood sample that reveals information about FSH and AMH guides the fertility doctor’s further course of action.
Blood tests are typically conducted within the first five days of a woman’s menstrual cycle, known as the early follicular phase, to assess hormone levels. These tests, including the measurement of follicle-stimulating hormone (FSH) levels, provide an approximate measure of ovarian reserve, which refers to the number of eggs remaining in the ovaries.
If ovarian function is declining due to age, the FSH level may be elevated. Another test gaining popularity is the measurement of anti-Müllerian hormone (AMH) in the blood, which offers a more accurate assessment of ovarian reserve. Additionally, an ultrasound scan can be performed during the early days of the menstrual cycle to count the number of follicles present in the ovary, known as the antral follicle count.
These tests help estimate the likelihood of the ovaries responding to hormonal stimulation with FSH-like medications during assisted reproduction. Furthermore, a progesterone blood test can be conducted on day 21 of the menstrual cycle to confirm ovulation, ensuring that eggs are being released from the ovary.
Those who have higher FSH and lower AMH than normal most likely have low egg reserves. AMH reflects the number of eggs in the body. A fertility expert assesses these hormone levels along with a transvaginal ultrasound to observe the number of visible follicles before making an accurate diagnosis. Vijaya Kumar and his wife were facing exactly this issue.
Follicular Monitoring and Ovulation Induction
Learn how both these procedures can help you conceive.
Does Low AMH (Anti-Mullerian Hormone) Levels Affect Fertility?
Having low AMH (Anti-Mullerian Hormone) levels does not directly cause infertility. Instead, it indicates a low ovarian reserve, which means there is a limited number of eggs developing in the ovaries.
As a result, the likelihood of a mature, high-quality egg being released and fertilized each month decreases. Additionally, as a woman ages, the quality of her eggs can be affected. This, in turn, affects a woman’s reproductive health. It also increases the risk of early miscarriages due to abnormalities in the eggs.
Causes of Low AMH
The AMH (Anti-Müllerian Hormone) level is influenced by the number of follicles developing in the ovaries. When examining the factors behind low AMH levels, the age of the woman plays a significant role. Ovarian reserve tends to decline in a woman’s mid-30s and becomes even lower for women who are 40 years of age and older.
Some of the factors that can cause low AMH levels include:
- Age
- Hormonal imbalance
- Inherited genetic causes
- Endometriosis
- Cancer treatment
- Autoimmune attack on the ovaries
- Other environmental causes
These factors can contribute to a decrease in AMH levels, indicating a lower ovarian reserve and potentially impacting fertility.
What are the Treatment Options for Low Egg Counts and Low AMH Values?
Upon diagnosis, Dr. Jagrati Laad will discuss suitable treatment options tailored to your specific needs. These options may include:
Hormonal Therapy: By using medications such as Clomiphene or Letrozole, egg production is stimulated, which improves ovulation.
In Vitro Fertilization (IVF): IVF involves extracting eggs, fertilizing them with sperm in a laboratory, and transferring the resulting embryos into the uterus.
Egg Donation: In cases where the egg reserve is severely depleted, using donated eggs from a young and healthy donor can increase the chances of a successful pregnancy.
Lifestyle Modifications: Dr. Jagrati Laad may suggest adopting a healthier lifestyle, including regular exercise, a balanced diet, stress reduction techniques, and DHEA supplements.
Conceiving naturally after hormonal treatment for low egg reserve and a low AMH value is possible with the right medical guidance and support. Dr. Jagrati Laad , an esteemed gynecologist in Pune, has helped numerous couples overcome fertility challenges and fulfill their dreams of starting a family. In the words of Vijaya Kumar, “Dr. Jagrati Laad is an excellent gynecologist. Definitely recommend her.”
If you’re struggling to conceive, facing hormonal imbalances, or have been diagnosed with low egg reserve, we encourage you to reach out to Dr. Jagrati Laad .
With her expertise, personalized care, and evidence-based treatments, she will provide you with the best possible chances of achieving a successful pregnancy. Increase your fertility potential by consulting her at the earliest possible time.
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