Low Ovarian Reserves: What can we do about it
Low Ovarian Reserves and abnormal FSH - what it means and what to do
As a population, we’re having babies later in life than in generations past. One of the things we’re hearing more about now than ever before is Low Ovarian Reserve and/or High FSH Hormone. What is it? Is there anything we can do about it?
Fun Fact #1: You DON’T Run Out Of Eggs!
Did you know that you have about 500,000 primordial eggs at puberty and you only release 1 a month?? In case you’re interested, it would take you over 41,000 years to use them all up! It is possible for your body to slow down on the process of maturing the eggs, meaning less eggs are available for conception. This is called Low Ovarian Reserve.
Low Ovarian Reserve is the term used when a low reading of AMH is present in your blood test. AMH stands for Anti-Mullerian Hormone. This hormone is secreted by ovaries to prevent hyperstimulation. It’s the body’s way of making sure there is a low risk of multiple births. This is why your chance of having twins can go up, as you get older. It is also an indicator of how many follicles are available for ripening.
See research on why AMH isn’t the best test for your fertility!
High FSH means that the ovaries aren’t responding the way they should to the signals coming from the brain. The signal should be telling the ovaries to stimulate follicular development (that is, to get the egg ready to be released), but if this isn’t happening the way it should, the brain releases more FSH than normal.
Stop! Take a deep breath…
Having one, or even both, of these readings out of range can feel soul-crushing. But now’s the time to take a deep breath and avoid panic. It doesn’t mean you’re running out of eggs. It also doesn’t mean you’re too old. It just means there’s some work to be done to help the health of your ovaries and eggs.
Fun Fact #2: FSH & AMH Can Be Reversed
It’s true! FSH and AMH aren’t related to your chronological age (the candles on your birthday cake), but they are related to your biological age (the story of what’s happened inside your body). They can be a reflection of inflammation levels, of how well you’ve looked after your body mentally and physically in the past. That means, they can change for the better in the future.
AMH levels will lower in the second half of your menstrual cycle and in winter when you’re getting less Vitamin D. Before you panic, ensure your AMH test was taken early in your cycle - somewhere around day 3 - and your Vitamin D levels aren’t low. Those two factors will affect your AMH levels.
FSH levels also change throughout your cycle so take these on day 2 or 3 to find the accurate baseline levels.
Fun Fact #3: It’s not JUST About The Eggs!
Many women (& some doctors!) assume that once a lady is of a certain age it MUST be the egg quality that's to blame for not falling pregnant yet.
That might be true. It might only be partially true. It might even be false.
Assume nothing, rule out everything.
It takes two to tango! So often in clinic we see suboptimal sperm counts that have been declared as 'fine' and people are told that it's only the egg quality that's the problem.
Ensure your man or donor has had their sperm checked in the last 6 months and that levels are really good for easy conception.
Even if you have higher FSH or lower AMH, there can be a whole host of other contributing factors affecting fertility including:
Blocked tubes and other structural issues,
low progesterone,
abnormal thyroid function,
abnormal immune or clotting factors
All these things should be ruled out before assuming it's just your age or the eggs.
If you're doing IVF, INSIST on seeing the embryologist’s report on the retrieved eggs and embryos. Unless it specifies there's an issue with the shape of the egg, outside layer of the egg or how the insides of the eggs look under a microscope - IT’S NOT THE EGGS.
If you have reasonable numbers of eggs collected per cycle and reasonable numbers making it to the fertilisation stage, but you're getting minimal embryos making it to day 5 - it's likely not the eggs, lovely.
Fun Fact #4 - You Can Take Steps to Help
The most important thing you can do to help is to Be Kind To Your Body.
Here are some practical things you can do to help:
Eat Clean
Don’t burn the candle at both ends! (Long term inflammation and exhaustion increase FSH and decrease AMH)
Allow for deep, restful activities (trade in the 10km run for some yoga or walking)
Do things that bring you joy (outside of exercise and performing well at work).
If you’re a smoker - make it the top of your priority list to kick that habit.
Test your FSH on day 3 of your period. (No GP appointment needed!)
Check what’s in your skin products! Don’t forget that skin absorbs everything you put on it. Parabens and fragrances can be hormone-disrupting. If you wouldn’t eat it, don’t put it on your skin.
And don’t forget the regular Acupuncture treatments. Acupuncture is designed to be restful and relaxing, which helps to rebalance hormones. It can increase blood flow to the reproductive organs, making sure those ovaries can pick up messages from the brain and help mature beautiful eggs.
Zhou et al 2016 studied women with low ovarian reserve who did weekly treatments for two menstrual cycles before doing IVF compared to those who had no Acupuncture alongside their IVF treatments.
“The number of high quality embryo were all increased in the observation group. Also, the implantation rate and the clinical pregnancy rate were improved”
You’ll find more research here, if you’re interested!
Get started with that self-care today!
