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Diminished ovarian reserve versus ovarian aging: overlaps and differences
Baris Ata1,2, Ayse Seyhan3, Emre Seli2,4
1Department of Obstetrics and Gynecology, Koc University School of Medicine, Istanbul, Turkey.
Current Opinion in Obstetrics & Gynecology
|March 15, 2019
Summary
Diminished ovarian reserve, a lower egg count, does not necessarily mean lower egg quality. Studies show similar fertility and pregnancy outcomes for women with diminished ovarian reserve compared to those with normal reserves.
Area of Science:
- Reproductive Endocrinology
- Gynecology
- Infertility Research
Background:
- Diminished ovarian reserve is generally understood as a quantitative decrease in the oocyte pool.
- The relationship between quantitative decline and oocyte quality remains an area of investigation.
Purpose of the Study:
- To determine if a quantitative decline in ovarian reserve is invariably associated with a qualitative decline in oocyte quality.
- To review current evidence on oocyte quality in women with diminished ovarian reserve.
Main Methods:
- Review of studies on natural conception rates in women with diminished ovarian reserve.
- Analysis of data on pregnancy loss and fetal chromosomal abnormalities.
- Evaluation of outcomes in assisted reproductive technology (ART) cycles, including euploid blastocyst development.
- Comparison of ART outcomes between women with diminished and normal ovarian reserve.
Main Results:
- Natural conception rates are comparable between women with diminished ovarian reserve and age-matched controls.
- Evidence does not consistently indicate a decline in oocyte quality or increased pregnancy loss in women with diminished ovarian reserve.
- Oocytes from women with diminished ovarian reserve show similar potential for euploid blastocyst development in ART cycles.
- Pregnancy loss risk in ART is not significantly increased for women with diminished ovarian reserve compared to controls.
Conclusions:
- A quantitative decline in ovarian reserve may not necessarily correlate with a qualitative decline in oocyte quality.
- Younger women with diminished ovarian reserve may not exhibit the age-related decline in oocyte quality.
- Ovarian aging's impact on oocyte quality may be distinct from the quantitative decrease in ovarian reserve.
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