Low ovarian reserve

What is low ovarian response?

Ovarian response is understood as the number of mature oocytes obtained after an ovarian stimulation process. In general, and although there is no consensus among the different scientific societies, it is established that a woman is a low responder or has a low ovarian response (BRO) when at least two of the following circumstances occur, or if this low response occurs after two processes of maximum stimulation.

  • Maternal age ≥ 40 years, or any other risk factor for BR (surgery, endometriosis, chemotherapy, having only one ovary, etc.)
  • A poor ovarian response in a previous cycle. That is, having obtained three or fewer oocytes after performing conventional ovarian stimulation.
  • Ovarian reserve test with altered results that indicate a low ovarian reserve such as an antral follicle count equal to or less than 5-7 or giving a blood value of anti-Müllerian hormone less than 1.2 ng.

At Cornel we talk about low ovarian response when the result obtained from the ovary after ovarian stimulation is lower than what can be expected, both in quantity and quality of the oocytes. In this sense, as specialists in highly complex reproductive medicine, we work on stimulations in a very controlled and personalized way, taking into account the criteria of quantity, but also quality.

What is low ovarian reserve?

Ovarian reserve is the number or quantity of eggs that a woman has in her ovaries.

Women are born with a finite number of eggs or ovarian reserve that is progressively reduced with each menstruation. The relationship between ovarian reserve and age is decisive when it comes to achieving pregnancy. In general, the best age to become a mother is around 20 years old. From the age of 30, female fertility begins to decrease and, from the age of 35, this decrease becomes very pronounced. At 40 years old, the possibility of pregnancy naturally is only 5% in each cycle.

Causes of Low Ovarian Response

The main cause of low ovarian response is having a low ovarian reserve mainly due to age, however, it is not the only cause.

  • Age
  • Low ovarian reserve due to genetic causes
  • Women with reduced ovarian mass due to chemotherapy, ovarian cysts, etc.
  • Endometriosis
  • Genetic causes
  • Lifestyle habits (tobacco, alcohol, high exposure to toxins, etc.)

Highly personalized stimulation strategy

Although one of the main causes of low ovarian reserve is age, it is true that some women are born with a lower number of oocytes or their loss is accelerated by reasons external to the ovary such as surgery, infections, endometriosis, autoimmunity, among others.

In any case, the consequence is that biological age does not correspond to ovarian age. Finding a fertility clinic that knows how to distinguish the nature of the low reserve, as well as its therapeutic approach and management, is not always easy.

At Cornel we work hand in hand with the best specialists to determine the most appropriate diagnosis. Only then do we develop and apply highly personalized and differentiating stimulation strategies. We set ourselves the goal of selecting the optimal cycle that will ensure the best results.