Supporting IVF Outcomes in Low Ovarian Reserve
Low ovarian reserve is becoming a more common diagnosis as more and more patients decide to postpone their decision to conceive in to later years. While the incidence of low ovarian reserve increases with age, there are various cases where this can occur at young ages, in some severe cases as young as late teens or early 20s. This earlier onset of low ovarian reserve is usually auto-immune related and called premature ovarian insufficiency (POI). Decreased ovarian reserve can also be a result of surgeries on the ovary, such as the removal of endometrial lesions.
Treatment of low ovarian reserve with conventional fertility treatments become challenging as patients diagnosed with low reserve tend to produce fewer follicles during in-vitro-fertilization (IVF). Concurrently the quality of the eggs tends to be lower and the total antioxidant capacity (TAC) decreases with age, allowing for increased damage to the follicles and their DNA integrity.
In general, low ovarian reserve was diagnosed in patients in this study if the met one of the following criteria:
Age is greater than or equal to 40
A previous IVF that produced 3 or less follicles
AMH level less than or equal to 1.1ng/mL
An Antral follicle count (AFC) of less than 7 follicles total (from both and left ovaries)
A novel method of supporting fertility outcomes for patients with low ovarian reserve is fertility acupuncture. A new systematic review research paper published in Korea last summer found that the use of the newer fertility acupuncture treatment protocols for patients with diminished ovarian reserve was attributed to about a 13% increased likelihood for clinical pregnancy when compared to patients that did not receive fertility acupuncture and patients that received fertility acupuncture seemed to produce more follicles with IVF (increased eggs retrieved during IVF retrieval), and anti-mullerian hormone (AMH) level and antral follicle count (AFC) tended to be higher in patients receiving fertility acupuncture as well.
Overall, there were no major side effects reported from the fertility acupuncture. Only small number of patients had mild allergic reactions.
Limitations of the study included small population sizes and the clinical trials were open label trials.
However, considering the high safety of the protocols and potential improvement in fertility outcomes it can be recommended to patients with appropriate counselling around the potential benefits and risks of fertility acupuncture therapies.
This article is in no way a replacement for medical advice or medical care, it is advised that anyone concerned about their Health should speak with their Naturopathic Doctor. Please discuss with your healtcare provider and only make changes to your medications regimen if recommended by your doctor and under their guidance.
Jang, S., Kim, K., & You, S. (2020). Acupuncture for in vitro fertilization in women with poor ovarian response: A systematic review. Integrative Medicine Research, 9, 100562.