Diminished Ovarian Reserve in New Jersey
What is Ovarian Reserve?
Ovarian reserve is the term used to refer to the pool of eggs present in the ovaries at any given time. It reflects the women’s current supply of eggs and is closely associated with reproductive potential.
Women are born with all the eggs they will ever have and as they get older they have fewer eggs in their ovaries and their ability to get pregnant decreases. The loss of egg reserve can be accelerated by a number of factors such as life style, smoking, genetics, exposure to pollutants, surgical removal of part or all of the ovary, endometriosis and other medical conditions. Having Diminished Ovarian Reserve predicts having lower fertility.
Why Measure Ovarian Reserve?
Although female fertility declines with age, the pace of decline varies among individuals. Women of the same age can have widely differing ovarian reserve. Results of ovarian reserve tests correlate with fertility success and response to treatment.
How Do You Measure Ovarian Reserve?
FSH is Follicle Stimulating Hormone. This hormone is made by the pituitary gland at the base of the brain. Its purpose is to stimulate the maturation of the egg follicles awakening that month. When fewer eggs are available for awakening, their reduced feedback to the FSH-producing cells is weak so the pituitary gland shoots out more FSH. An FSH test result above 10-12 is concerning. A level over 15 denotes a low number of eggs and predicts a lowered chance for successful pregnancy. Normal pregnancies in women with an FSH over 20 are quite rare except in woman under the age of 30. The test is only valid if it is drawn soon after the start of the period. “Day 2 or 3” is the common instruction for timing the blood test. A normal FSH result does not exclude the possibility that the woman has Diminished Ovarian Reserve.
Antimullerian hormone or (AMH) is a hormone secreted by each dormant sleeping egg follicle. The more eggs a woman has, the higher the AMH level in her blood test. AMH levels can be checked at any time during the menstrual cycle. Normal values are 1.0 or higher. Low AMH levels (less than 0.7ng/ml) are associated with poor response to fertility treatment.
Ovarian Ultrasound Imaging (Antral Follicle Count)
A one-minute ultrasound test in the fertility doctor’s office can visualize the number of medium sized follicles (2-10 mm) in the ovaries by using sound waves. The number of so-called antral follicles correlate with the number of dormant eggs still present. A low antral follicle count (less than 6 total antral follicles) is associated with diminished ovarian reserve.
What do these tests tell us?
The main goal of ovarian reserve testing is to try to predict a women’s response to fertility treatment. Women with Diminished Ovarian Reserve have decreased fertility potential but testing cannot identify which individual is going to conceive or not. Younger women with Diminished Ovarian Reserve have reduced egg numbers but may have normal egg quality, while older women with normal ovarian reserve may have a good egg number but an age appropriate decline in egg quality.
Our Diminished Ovarian Reserve (DOR) Program
For more than 25 years, South Jersey Fertility Center has been the leading center for helping women with diminished ovarian reserve achieve their dream of building a family. Our specialists have more than 100 years of combined experience and continue to offer individualized and comprehensive fertility treatment options to women with low ovarian reserve.
Our Low Ovarian Reserve Treatment Options in New Jersey:
1. Superovulation therapy with intrauterine insemination:
This method uses oral medications (such as Clomid) or FSH injectables to grow multiple egg follicles, combined with intrauterine insemination (IUI), which helps deliver motile sperm directly to the uterus
2. In Vitro Fertilization (IVF):
A highly individualized approach to ovarian stimulation is crucial to maximize IVF success rates in women with diminished ovarian reserve. The following are examples of different protocols that we use to optimize ovarian response in IVF cycles:
• Estrogen Primed Antagonist Protocol
• Micro-dose Lupron Flare Protocol
• Natural start IVF cycle without pretreatment with birth control pills
-Minimal Stimulation IVF
• Human growth hormone, Enzyme CoQ10 and DHEA supplementation to improve ovarian response
• Embryo banking cycles
3. Egg banking:
Egg banking (freezing) cycles for single women at risks for diminished ovarian reserve.
4. Acupuncture and Holistic therapy:
We offer services such as yoga, acupuncture, massage and other resources to help patients through their fertility journey.
5. Donor Eggs
Utilizing donated eggs gives by far the highest chance for successful pregnancy. South Jersey Fertility Center has been providing donor eggs for patients with Diminished Ovarian Reserve with exceptional success for over 20 years.
Our patients have the option to choose a donor from our large and diverse pool of qualified donors. We also partner with My Egg Bank which allows our patients to receive existing frozen eggs from donors across the country.
The specialists at South Jersey Fertility Center are highly experienced at helping patients achieve their dream of building a family. We serve patients in New Jersey and Pennsylvania with offices located in Marlton, Burlington, Sewell, and Egg Harbor Township. We are easily accessible to patients in Burlington, Mercer, Atlantic, Camden, Ocean and Bucks Counties. Contact us today for more information!