Physicians Ovarian Reserve
The definition of “ovarian reserve” includes oocytes pool in the ovary, clinically correspondent with the ovarian response in controlred ovarian hyperstimulation stimulation (COH).
Reproductive ovary age
Women reach their fertile peak between 20 and 30 years of age and their menstruation stops at about 50-years of age. In this period the axis hypothalamus-pituitary-ovary (HPO) undergoes various changes.
The follicular ovarian depletion is the final natural course in reproductive age and in this process in included the entire HHO axis. Sometimes, with the advancing of age, the physiological function of the reproductive system slows down earlier. Some malign diseases, could also lead to dysfunction of the reproductive system. The ovary is an organ, which loses almost entirely its reproductive and endocrine function in menopause.
The probability for spontaneous conception of younger women is 20-25% in each menstruation cycle, and this chance decreases by up to 5% for women near the end of their 30-ies and in the beginning of their 40-ies. With the advancing of the reproductive age the percentage of spontaneous abortions rises, and also the risk of congenital malformations of the fetus, such as the Down syndrome. The reduced possibility for women in advanced reproductive age to get pregnant is in result of worsening of the quality of the eggs. It is important for those women to know that if they fail to achieve spontaneous pregnancy after not more than three menstrual cycles, they should seek consultation with a reproductive endocrinologist.
Epidemiological research data indicate that in 10% of women the menopause occurs earlier – before the age of 45 years (normally, the menopause in 80% of women occurs about their 50-ies years of age), and in 1% of the female population the ceasing of the menstrual cycle is established before they complete 40 years of age. In those cases it is frequently observed unsatisfactory ovarian response to stimulation for the purpose of infertility treatment. In accordance with Nikolaou and Templeton the process of fast depletion of the ovarian reserves starts approximately 13 years before the definitive stop of menstruation, i.e. for 45 years old women in menopause this process has started when they were 32 years old. The early depletion of the ovarian reserve of such women needs to be diagnosed.