Determining the age of the ovary (ovarian reserve) means having information about the number of egg cells (follicle) in the ovaries. Determination of ovarian age has gained more importance with the introduction of more reliable measurement methods. In some cases, it is very important to determine the ovarian capacity (ovarian reserve), in other words, the age of the ovary for a woman.
However, it is useful to remind the negative consequences of incorrect or incomplete evaluation of the ovarian reserve.
Normally, it tends to decrease in women from the time the egg cells are formed until the menopause. That is, the number of egg cells in women begins to decrease from their life in the mother's womb. The number of egg cells reaches the highest number in the womb when the baby girl is 6 months old, during this period the number of egg cells is about 7 million. It is normal for ovaries with a dynamic physiology to gradually decrease in the number of egg cells. For this reason, the number of egg cells in a girl child at the time of birth is about 2 million. This decrease in the number of egg cells continues throughout life, while the number of remaining egg cells is only about 400 thousand during puberty. Here, women use these remaining 400 thousand egg cells during the reproductive age of about 35 years (between 15-50 years).
Figure-1: The number of egg cells in the ovary has a dynamic physiology and tends to decrease throughout life. This decrease starts in the womb before birth.
This decrease in egg cells, which starts in the mother's womb, can sometimes be faster than it should be. Normal exhaustion may occur at the age of 45-50 years, ie earlier than at menopause (premature ovarian failure, early menopause). Therefore, it is very important to detect the number of egg cells (follicular reserve) in the ovaries. However, some compensatory mechanisms occur depending on follicle reduction in the early period of reproductive aging. Therefore, clinical examinations, symptoms and current hormonal evaluations may not always reflect the fact of decreased follicle.
We can summarize the main benefits of knowing the ovarian age (ovarian reserve) as follows:
1. Informing the patient about the approximate pregnancy rate,
2. Guiding the timing of pregnancy in elderly patients,
3. Choosing the right treatment in the treatment of infertility and using time well,
4. Borrowing someone else's egg (egg "oocyte" donation) or adopting a child can assist in obtaining
5. In case the woman is treated for any reason (surgery, chemotherapy, radiotherapy), it guides to determine the condition of the ovary and to take the necessary precautions.
A 38-year-old patient of mine, who was a healthcare worker, was always postponing her even though she wanted a child. He explained this waiting comfort by the fact that his tests were normal. The prejudice of “I can get pregnant whenever I want” was in his comfort. One day, I asked her to have a new and more reliable test, the AMH test, and the result showed that this patient's ovarian reserve was considerably reduced. She was almost extinct, meaning she was very close to menopause. I asked him not to panic. However, despite trying for a few months, no results, considering her age and test result, we tried in vitro fertilization and we were successful. If this patient had continued to wait with the same ease, relying on old and poorly reliable tests, perhaps she would not have been able to conceive.
