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Poor Ovarian Reserve and IVF Outcomes

Poor Ovarian Reserve and IVF Outcomes

In general, women with low ovarian reserve will have difficulty in achieving pregnancy. But what about in advanced reproductive technology (ART) such as IVF?

Ovarian Reserve

Let’s first discuss what the term ovarian reserve means. Ovarian reserve refers to quantity, or number, of eggs remaining that are available to achieve pregnancy. We are unable to measure this exactly, but there are tests that can give us insight into ovarian reserve. Abnormally elevated cycle day 3 labs, or estradiol and FSH, indicate that the brain has to work harder to stimulate the ovaries each month for ovulation to occur. As women get older or approach menopause, FSH levels will increase suggesting that the number of eggs remaining has begun to decrease, thus indicating decreased ovarian reserve.

Poor ovarian reserve and IVF stimulation

Women with poor ovarian reserve will have a decreased chance for a successful conception each month. Unfortunately this does not change with infertility treatments. However, IVF may provider a higher chance for pregnancy than relying on spontaneous conception or lesser fertility treatments. As the brain is already working harder to attempt to stimulate the ovaries on its own, you may require higher doses of medications to achieve an appropriate response for IVF. Your doctor may also choose to create an alternate IVF protocol to maximize your ovarian response.

What to expect

It’s important for a woman with known decreased ovarian reserve to be aware that her stimulation results may not be as vigorous as women who are younger or have normal ovarian reserve. Also, as ovarian reserve decreases, there is a higher likelihood that egg quality may be decreased as well, adding to the difficulty in conceiving and increasing the risk of unfavorable pregnancy outcomes. Remaining realistic about success rates is the safest approach.

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Kaylen Silverberg, M.D.

Originally from Dallas, Texas, he received his undergraduate degree from Vanderbilt and attended medical school at Baylor College of Medicine. He completed his Obstetrics & Gynecology residency at Vanderbilt University Medical Center and his infertility fellowship at the University of Texas Health Science Center in San Antonio. Dr. Silverberg is actively involved in infertility research and has published extensively in the infertility literature. He was recently honored by the American Fertility Association with the Family Building Award, and he is recognized annually by the Best Doctors in America. Dr. Silverberg. a fertility specialist, is board certified in both Obstetrics & Gynecology and Reproductive Endocrinology.