Low Ovarian Reserve: Naturopathic Treatments for Egg Quality and Fertility
Low ovarian reserve is a reduced number of follicles remaining in the ovary. It is estimated with a combined estimate from various lab tests: follicle stimulating hormone (FSH), estradiol (estrogen), anti-mullerian hormone (AMH), and antral follicle count on an ultrasound test.
An increase in FSH, decline in the antral follicle count, estradiol, and AMH levels suggests declining ovarian reserve. Factors that can lead to an accelerated decline in ovarian reserve include smoking, unhealthy diets, and genetic inheritance.
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The number of follicles in the ovarian reserve cannot be changed, but there is an important factor which can be changed. As ovarian reserve declines, so does the quality of the follicles/eggs. Declining egg quality means that these follicles are now less likely to fertilize, implant, and lead to healthy pregnancies without complications.
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There are several evidence based approaches to supporting egg quality for Women with low ovarian reserve or advanced maternal age.
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There are many nutrients which have been shown to reverse the damage to eggs that occurs with increased age or declining reserve.
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CoQ10 is one of these important nutrients, when used in the correct therapeutic concentration, it has been shown to reduce the risk of chromosomal issues in the eggs during IVF and improve the integrity of the cell wall of the eggs.
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Vitamin D has an important role in increasing AMH levels and supporting optimal fertility and egg quality.
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Folic acid can help to support quality of follicles as well reduce the risk of neural tube defects during pregnancy.
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There are many more customized protocols based on clinical trials which have been shown to significantly improve success rates for IVF, ICSI, IUI and natural fertility cycles for Women with low egg quality. Please consider seeing a Naturopathic Doctor to help you take the guess work out of what works and what is safe for you during fertility treatments.
An incredible role that an egg has during fertilization is that it is actually able to repair the damage to the DNA of sperm cells during. As sperm cells are incredibly vulnerable to damage, this repair of the DNA helps to provide a healthier embryo with higher chances of pregnancy. Unfortunately, this capacity to repair sperm DNA declines significantly after the age of 35 or in Women with low ovarian reserve.
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It is vital, to improve the success rates of the fertility treatments, to treat the partner as well and provide a treatment which can greatly reduce the oxidative stress induced damage to sperm DNA which can lead to an increase in something called Sperm DNA Fragmentation rates. Higher sperm DNA fragmentation has been associated with a decline in IVF success rates and higher chances of miscarriage, particularly in the first trimester. Speak to your naturopathic doctor to discuss strategies and treatments to prevent this from happening or improving sperm DNA defence mechanisms.
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Who does Low Ovarian Reserve Affect?
Low ovarian reserve can occur at any age, although it usually starts to occur after the age of 35. However, there are many exceptions to this rule. For example, if you genetically were born with fewer embryos, then you may have an earlier decline in the ovarian reserve. Some Women are diagnosed with premature ovarian insufficiency as the decline in ovarian reserve occurs very early on, in some cases in the early 20s up to early 30s. The decline in ovarian reserve may be due to genetic reasons or auto-immune factors. In the case of polycystic ovarian syndrome, the ovarian reserve tends to decline at a later age rather than earlier. So for Women above the age of 35 that have PCOS, they may be able to retrieve more eggs/follicles than an age equivalent patient without PCOS.
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Can Ovarian Reserve be Increased?
Unfortunately, the ovarian reserve cannot be changed. This is a predetermined pool of follicles that develop while in-utero. The most important thing to change is the quality of the follicles. To improve your chances of conceiving with fertility treatments if diagnosed with low ovarian reserve, the key is to improve the quality of the follicles that are remaining. Improving the quality of the follicles through micronutrient therapies have been shown to significantly improve the integrity and quality of the follicles, and improved quality follicles are more likely to develop in to high quality embryos (which are more likely to lead to a healthy pregnancy).
Can Supplements help me get Pregnant?
A research paper reviewing multiple studies found that the utilization of certain micronutrients can help to increase your likelihood of conceiving. In some cases, patients were twice as likely to conceive naturally compared to patients that did not use the supplements. Additionally, certain micronutrients have demonstrated increased IVF success rates for Women with low ovarian reserve and low egg quality.
Additional Therapies to Help me Conceive
Alternative therapies to help support egg quality include Intravenous Vitamin Nutrient Therapies. They allow for the delivery of high dose antioxidants and nutrients to support healthy egg growth and protect them for the damaging effects of oxidative stress. As ovarian reserve declines, the body’s ability to reduce oxidative stress on its own deteriorates, and utilizing the oral supplements and IV micronutrients help to support the total antioxidant capacity of the body.
It is critical to have your partner get tested for more advanced sperm function, beyond the basic sperm analysis done at the start of your testing at a fertility clinic. Advanced testing to check for DNA fragmentation rates and sperm morphology can help signal to the integrity of the DNA of the sperm cells. To illustrate the importance this has on success rates, a large review of data from patients going for IVF found that when male patients were treated with micronutrients to support optimal sperm health, there were almost three times more likely to have a healthy pregnancy when compared to patients that did not use the micronutrients and almost twice as likely to have a healthy baby that did not end in miscarriage when compared to patients that did not use the micronutrient treatment.
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This information is presented for educational and informative purposes only. This is not a replacement or substitute for medical advice from your fertility doctor or physician. If you have any questions or concerns regarding fertility drugs, please follow-up with your fertility