1. What is PCOD/ PCOS AND HOW IS IT DIAGNOSED?
Since the starting of life, all females are born with a fixed number of eggs in their body, approximately 1-2 million. At the time of puberty, that is when periods start, only 3-4 lakh eggs remain. After that every month, a group of eggs is selected, out of which one egg matures, ovulates and gives you 1 chance of conceiving. But in this process approximately 1000 eggs die every month. So with increasing age, the number of eggs in your body keeps on decreasing. The number of eggs remaining in your body at a particular point determines your OVARIAN RESERVE.
2. WHAT ARE THE TESTS TO DETERMINE YOUR OVARIAN RESERVE?
There are 2 methods to determine your ovarian reserve. First is Transvaginal Ultrasound/ TVS done at the second day of your menses. By this doctor checks the number of small follicles, also called as antral follicles in both your ovaries. It is called AFC (ANTRAL FOLLICLE COUNT). The second is blood test- AMH (ANTI MULLERIAN HORMONE). Both of these tests in combination gives an idea about your Ovarian reserve.
3. WHAT FACTORS INFLUENCE OVARIAN RESERVE?
AGE is the most important influencing factor. The ovarian reserve starts decreasing after the age of 30, and decreases very rapidly after the age of 35. This decrease is irreversible. It also depends on person to person and GENETICS of the individual. INDIAN population in general has poorer ovarian reserve as compared to others. It also decreases rapidly when you take multiple TREATMENT FOR INFERTILITY especially medicines for ovulation induction. Certain medical conditions like endometriosis, cancer, chemotherapy, radiotherapy also leads to fall in Ovarian Reserve.
4. HOW DOES POOR OVARIAN RESERVE EFFECT FERTILITY?
The number and quality of eggs decreases with decreasing ovarian reserve. The chances of chromosomally abnormal i.e. unhealthy eggs and embryos increases. This decreases the chances of pregnancy and also increases the risk of miscarriages. Hence poor ovarian reserve has a detrimental effect on fertility. These patients also tend to attain menopause earlier.
5. WHAT ARE THE TREATMENT OPTIONS?
If your ovarian reserve is low, you should plan pregnancy as soon as possible. You should opt for advanced treatment options like IUI and IVF earlier, so as to maximise your chances of conceiving. If you are planning to delay pregnancy, then you can opt for freezing your eggs/ embryos at an IVF clinic at a younger age. There are some medicines which the doctor can prescribe which can help in improving your egg quality but they are not very helpful. In extreme cases, you may have to opt for IVF using donor eggs, if your egg count is very low or all other treatments have failed.