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Female ovarian reserves diminish with age and consequently, so does a woman’s fertility. From the age of 35, women have about 10 % of their eggs left. This percentage progressively decreases and, between 10 and 15 years before menopause, the decline is accentuated.
Each woman’s ovaries contain about 750 000 eggs at birth. From puberty, there are about 300 000 eggs left. In each menstrual cycle, about 1000 eggs develop. Only one of them reaches ovulation, the most dominant of the cycle and the rest are lost. Therefore, as menstrual cycles pass, the number of reserve eggs capable of being fertilised correctly and leading to a pregnancy is reduced.
A woman’s ovarian age does not correspond exactly to her biological age. There are women of the same age who have different ovarian reserves.
To find out a woman’s ovarian reserve, that is, the number of eggs per cycle that she can develop at a given time in her life, a transvaginal ultrasound with antral follicle count (AFC) is performed in the first days of the cycle and an analytical determination of anti-Müllerian hormone (AMH) levels is done, which can be performed at any time during the ovarian cycle. An abnormal value of anti-Müllerian hormone can indicate premature ovarian insufficiency, also known as early ovarian failure.
The normal values according to age can be found in tables created by Institut Marquès, which you can download here. Other analytical parameters to consider are the basal hormones (FSH, LH, and oestradiol). These hormones are present on the second or third day of menstruation.
If the results of these tests indicate that a woman has a low ovarian reserve, her chances of achieving a pregnancy are lower than with a normal ovarian reserve. Therefore, to fulfil her wish to become a mother, she may opt for Assisted Reproduction treatments. The specific treatment is determined by evaluating other factors, such as the male factor and the age of the patient.
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