This starts to happen approximately 10 years or so, before a woman goes into menopause. The problem is that even though she will probably have plenty of eggs to be able to produce enough hormones to continue having regular monthly cycles, she may not have enough high-quality eggs needed to make a baby.
This development is called, oopause, or poor ovarian response. Since every woman is born with a fixed amount of eggs, which over time, of course, progressively diminishes, what is eventually left is a portion of eggs in the ovary, which is called the “ovarian reserve”. Now, as a woman ages, her reserve gets depleted, which means that she will have a lesser chance of having the type of egg that she needs to conceive with.
All females are born with approximately 1 million eggs, although by the time she has had her first period that number has probably dropped to around 400,000 or less. Then, the eggs that are left, will just stay in the ovaries, inactive and waiting, until such time as they become activated by hormones during a woman’s period. The issue then becomes about the quality of the eggs, which involves several important factors. First, it depends on just how prepared your eggs are to actually develop into embryos once they have been fertilized. For this development to happen, the egg needs to have good, normal and healthy chromosomes, as well as the ability to combine those same chromosomes with healthy sperm. (And although a man’s sperm quality does tend to go down with age also, the process is much slower and more subtle.) Without the correct number of chromosomes, your body cannot achieve a successful pregnancy. Second, your eggs need to have enough energy in order to be able to split after fertilization. Each egg contains tiny cell organelles called, mitochondria, which are what supplies the egg with energy, and without energy the egg would not be able to survive, let alone have the strength to develop into an embryo. And as a result of a woman growing older, the mitochondria create less and less energy, which means that any egg that becomes fertilized will simply run out of energy at some point and lose their ability to be able to divide. And third, is a woman’s age. Despite the testing that can be done on egg supplies, the age of a woman is still the best and only real way at the present time to have a guess about the quality of an egg. The best age is considered to be between 22 and 35, as chromosomal abnormalities begin to increase significantly in the mid to later 30’s. This does not, of course, mean that you cannot wait until your later 30’s or even early 40’s to have a child; it simply means that your chances of getting pregnant and having a healthy child go down as time passes.
The tests that can be conducted on a woman’s egg supply, which can at least help to give an estimate as to the number of eggs that are still considered to be of good quality, are as follows:
Day 3 FSH (follicle stimulating hormone) Test: This test will measure the level of FSH in your blood, and if your levels are high, this could be a possible indication of poor egg quality. This is done on the third day of your period (the third day of bleeding) and is known for giving a fairly reliable result.
Clomid Challenge Test (Clomiphene Citrate Challenge): This is a blood test that looks for FSH as well, and much the same as the FSH test, if the level is high, it means that the number of eggs in the woman’s body have dwindled. This test is performed over a short period of time, beginning between day 5 and day 9 of the menstrual cycle. At some point during this time period, you are given a dose of Clomid, and then on day 10, the FSH level of your blood is checked by using a sample of blood.
Anti-Mullerian hormone level test (AMH): This test has become used fairly regularly by fertility specialists as a part of the overall assessment of the ovarian reserve, by looking at the blood levels of the AMH hormone. In this case, a low level means a poor ovarian response. The test can be done at any point during your monthly cycle, and is also a blood test.
Antral Follicle Test: This test is done by using a vaginal ultrasound to count and measure these very small follicles. The number of follicles that you are able to see on the ultrasound is suggestive of the number of minuscule primordial follicles that are left in each ovary. Each one of the primordial follicles holds an immature egg which has the possibility to someday develop and ovulate. When you can only see a small number of antral follicles, that means that there are a lot less eggs.
A couple of other ways to help tell how a woman’s egg supply looks are not with actual “tests”, but with different methods that are as follows:
The response of the ovaries to injectable FSH: This is actually done as more of a treatment for infertility, however, the response of the ovaries after a woman takes this injection for stimulation, is quite often very informative as to the quantity of a woman’s eggs.
In vitro fertilization: This is also usually a treatment that is done for infertility, but it has its ways of helping to make some things clear. For example, during the incubation process of in vitro, there are sometimes clues to be found about why a woman has not conceived before, by looking at the eggs and embryos very carefully. The eggs may show things such as problems with maturation, they could be demonstrating poor morphology, or with fertilization, it could be something such as proper cleavage, or something else.
Although this may sound like an insurmountable obstacle, don’t despair, there are treatment options available. Here is a list of possible alternatives and treatments that are out there and can help you in your quest to have a child. They are:
In Vitro Fertilization (IVF): This is a process that involves the stimulation of both multiple follicles and eggs so that they develop. Then, the eggs are retrieved and fertilized in a lab, after which they are then transferred into the mother’s uterus. (This process can also be done with the use of donor eggs.)
Fertility Drugs: These drugs work by helping to promote the process of ovulation by stimulating hormones that will help mature an egg and then release it during each monthly cycle. There are many drugs out there, some of which include: Human Menopausal Gonadotropin, Clomiphene and Bromocriptine. There are others out there in addition to these, and have been used for many years to help women with the problem of infertility.
Superovulation and Intrauterine Insemination (IUI): In the case of superovulation, 2 to 3 eggs are stimulated and then brought to both maturation and ovulation. This is most often combined with the process of intrauterine insemination, where the prepared sperm is put directly into the woman’s uterus.
This particular process has a tendency to improve a couple’s chance at conception.
Ovarian Stimulation Protocols to Assist with In Vitro Fertilization:
These protocols include:
- Luteal Lupron Protocol
- Antagonist Protocol
- Flare and Micro-flare Protocol
These protocols are used to help “pump up” the ovaries, in order to assist with making enough eggs and follicles for the in vitro procedure. Without them, the ovaries will make only one egg per monthly cycle. These stimulating regimens include injections of FSH.
Here is a list of things that you can try at home, to help attempt to keep the ovaries or the “housing” for your eggs in better shape, as well as to protect the eggs themselves. The one important factor for this section is that these things be done for at least 90 days. The reason for this is due to the fact that the cycle of an egg’s journey toward the process of ovulation takes approximately 90 days, during which time there is a window of opportunity when specific aspects have the ability to alter the eggs.
This list includes:
- Drink 8, 8oz. glasses of pure water each day
- Massage your uterus and ovaries at least 4 times a week, starting the day after your period ends
These things will help to improve blood flow and oxygenation. Blood flow can decrease from having thick blood, not exercising enough and dehydration. Blood flow is also vital for good egg quality and health.
- Royal Jelly
- Dark Leafy Vegetables
- Sesame Seeds
- Halibut and Salmon
- Pumpkin Seeds
These are foods that can help support egg health.
The following is a list of things that can hurt the health of your eggs:
- GMO Foods
- Trans Fats
- Processed Foods
- Non-organic Meats and Dairy
- Low Fat Diet
A hormonal balance is very important to the health of eggs, but due to so many issues in the world, this is sometimes a little difficult to fix.
Here are some tips:
- Reduce exposure to xenohormones
- Use the well-known super food Maca
- Take the herb Vitex if your FSH levels are high
- Try to cleanse your system of any excess hormones
In addition to these things, try your best to de-stress whenever possible, and begin taking a prenatal multi-vitamin immediately, as this will help to prepare your uterine lining. It is also very important to take an antioxidant supplement blend, because antioxidants help to protect both the sperm and the egg from free radical damage. The amino acid, L-arginine, has been shown in studies, to assist with endometrial receptivity, ovarian response and the pregnancy rates in women who were receiving IVF treatments, if they supplemented in large portions. And as one final note, it has also been shown in studies that CoQ10 Ubiquinol supplementation improves both fertilization rates and egg health, in women who are over the age of 35 years old.
No matter what route you decide to take, just remember that there are options and hope.