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So, You Have the Ovaries of a 40-Year-Old?
by Kim Griffiths, March 10, 2014
We’ve heard it before. Patients with Diminished Ovarian Reserve, some of them in their late 20s or early 30s, are sent into a tailspin when they hear those dreaded words: “You have the ovaries of a 40-year-old.” Granted, they may have high FSH, low AMH, or not-so-promising Antral Follicle Count (AFC), but is DOR necessarily a death sentence for their ovaries?
Dr. Owen K. Davis, Associate Director of the In Vitro Fertilization (IVF) Program at the Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine at Weill Cornell Medical Center thinks not. “There is a misconception that poor ovarian reserve is tantamount to bad eggs,” but that simply isn’t the case, he explains.
Having diminished ovarian reserve means that a patient has relatively few eggs left that can potentially lead to pregnancy, but that does not mean those remaining eggs are, well, rotten.
“These patients may be more of a challenge with stimulation in IVF, but on a per egg basis, their egg quality is more commensurate with age than the number of eggs left in their ovaries.” Dr. Davis says age is a better predictor of success with IVF than a patient’s FSH level- good news for the 30-year-olds with DOR who have been told they have the ovaries or eggs of a woman much older. Truthfully, they still have 30-year-old eggs, just fewer eggs to work with.
For women over 40, there is a higher probability of needing an egg donor because they are much more likely to have chromosomally abnormal eggs, but women in their 30s with DOR have odds in their favor that their eggs are still healthy. “There is definitely a difference between quality and quantity,” Davis states.
Dr. Davis has observed those most misinformed are newly diagnosed with infertility just embarking on the path of fertility treatment. Those who have cycled before tend to be more knowledgeable about their actual egg quality and are, perhaps, more hopeful.