Ovarian reserve

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Overview of ovarian reserve in reproductive biology


Ovarian Reserve

The Wallace-Kelsey model illustrating the decline of ovarian reserve with age.

The term ovarian reserve refers to the capacity of the ovaries to provide egg cells that are capable of fertilization resulting in a healthy and successful pregnancy. It is a critical concept in reproductive medicine and fertility studies.

Physiology

Ovarian reserve is determined by the number and quality of follicles present in the ovaries at any given time. Women are born with a finite number of primordial follicles, which decline in number and quality as they age. This decline is depicted in the Wallace-Kelsey model, which shows a gradual decrease in ovarian reserve over time.

Assessment

The assessment of ovarian reserve is crucial for evaluating a woman's reproductive potential. Common methods include measuring serum levels of AMH (Anti-Müllerian Hormone), FSH (Follicle Stimulating Hormone), and performing an antral follicle count via ultrasound.

Factors Affecting Ovarian Reserve

Several factors can influence ovarian reserve, including:

  • Age: The most significant factor, with a natural decline in both the quantity and quality of oocytes as a woman ages.
  • Genetic factors: Certain genetic conditions can affect ovarian reserve, such as Turner syndrome and Fragile X syndrome.
  • Medical treatments: Chemotherapy and radiation therapy can significantly reduce ovarian reserve.
  • Lifestyle factors: Smoking and obesity have been associated with reduced ovarian reserve.

Clinical Implications

Understanding ovarian reserve is essential for diagnosing and treating infertility. Women with diminished ovarian reserve may have difficulty conceiving and may require assisted reproductive technology (ART) such as in vitro fertilization (IVF). It also plays a role in determining the timing of menopause.

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Contributors: Prab R. Tumpati, MD