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The importance of ovulation and egg quality
How can I know if I am ovulating?
If the patient has regular menstrual cycles, we have to think that she is ovulating. If she has cycle disorders, such as delays or irregularities, we should think that there could be an ovulatory problem. Ultrasound and hormonal analysis will lead us to a diagnosis.
The most frequent causes that prevent a patient from ovulating are:
- Polycystic ovaries: Depending on the kind of polycystic ovaries, a different treatment will be recommended. If there is overweight associated, the first thing would be to adopt dietary measures. However, in other cases the treatment consists in inducing ovulation by administering FSH hormone (follicle stimulant) subcutaneous injections, monitoring via ultrasound the development of the follicles and focusing on having sexual intercourse on ovulation day.
- Hyperprolactinemia: This is an alteration produced by an excess of secretion of the milk-producing hormone and puts the patient in a similar situation as in breastfeeding. It is solved with medication.
When these are the only causes of infertility, a pregnancy can be quickly achieved, on the first cycles, once ovulation returns to normal.
Are my eggs of good quality?
If the patient is over 35 years, this should be taken into consideration right from the start.
We know that the amount and the quality of the ovarian reserve of oocytes decreases with age, and that ovarian age does not always match biological age. The follicular amount of each woman is set at birth (they do not multiply, as it is the case in men) and, as years go by, the amount of reserve oocytes subject to fertilise correctly and lead to a pregnancy decrease.
In order to evaluate a woman’s ovarian reserve, it is necessary to carry out a transvaginal ultrasound on the first days of the cycle with a Basal Antral Follicle Count (AFC) and an Anti-Müllerian Hormone (AMH) analysis, which can be carried out at any time of the ovarian cycle. Other analytic parameters to be taken into account include basal hormones (FSH, LH and Oestradiol). These hormone tests are carried out on day 2 or 3 of the cycle.
If a hidden ovarian failure is diagnosed, the treatment will be In Vitro Fertilisation with donor eggs.
Anti-Müllerian Hormone (AMH)
Normal levels according to the woman’s age
|Woman’s age||Amount of mg/dL|