According to classical knowledge, women are born with eggs that they will use for a lifetime and no new eggs are produced. This article examines the question of why ovaries produce fewer eggs as women age.
It is a normal and physiological process that eggs in the ovary decrease with increasing age. Getting pregnant becomes more difficult after the age of 39-40 and is almost impossible after the age of 44. The decrease in ovarian capacity should not be perceived as equivalent to menopause.
In women, a divergence begins in reproductive and hormone secretion functions from the age of 37. While reproductive function decreases rapidly from this age, hormone secretion continues until menopause. This physiological change explains why individuals may experience difficulties conceiving children.
Ovarian capacity is depleted earlier in women with a family history of early menopause. These women may experience reproductive difficulties approximately 10 years before their genetically programmed menopause age.
Other Causes of Decreased Ovarian Capacity
Beyond age and genetic factors, decreased ovarian capacity can result from past ovarian surgeries, previous radiotherapy and chemotherapy, and heavy smoking (more than 10 cigarettes daily).
Indicators
Decreased reproductive function is indicated by menstrual bleeding occurring at shorter intervals, increased miscarriage rates in both spontaneous and treated pregnancies, and fewer eggs developing during IVF stimulation despite high-dose medications.
Prediction and Treatment
Poor ovarian response can be predicted through hormone testing (FSH, LH, Estradiol) and vaginal ultrasound examination. Less than 6 immature egg structures in both ovaries indicates low ovarian capacity. Treatment planning should transition to IVF more quickly when decreased ovarian reserve is present. Recent studies demonstrate stem cells exist in female ovaries, offering potential future treatments for women with low ovarian capacity.