Ovarian Function, Age, and Fertility!

The ovaries are an important part of the female reproductive system. In a normal scenario, a woman has two ovaries that lie on either side of the uterus. Their main function is to produce eggs and release them into the fallopian tubes. These eggs then travel to the uterus where they may be fertilized. The ovaries are also responsible for the release of estrogen and progesterone. These hormones help regulate the menstrual cycle.

The functioning of the ovaries is directly related to a woman’s age. When a girl is born her ovaries have approximately 2 million eggs. These are in the form of follicles. By the time she reaches puberty, this number would have reduced to around 400,000. It is believed that a woman releases only around 450 eggs during her entire reproductive period. This is less than 1% of the eggs she was born with. During each menstrual cycle, one of the follicles will mature into an egg and be released. At the same time, some follicles may die. Thus, as a woman ages, the number of eggs available reduces. By her 30th birthday, the rate at which eggs are lost increases. By her 40th birthday, a woman’s eggs will die rapidly. Without a healthy egg being released sperm cells will have nothing to fertilize. Thus, ovarian functioning decreases as a woman grows older. This implies that the risk of infertility also increases as a woman grows older.

Along with a decrease in the number of eggs available the quality of eggs also reduces with age. Thus, though the ovaries may release an egg even when a woman is in her 40s, the chance of these eggs being fertilized is very low. Even if the egg is fertilized, women who conceive a child after the age of 40 have a high risk of miscarriage. There is no direct way to assess the quality of a woman’s eggs but some tests may help indicate the chances of getting pregnant. This includes a Basal FSH to indicate the level of follicle stimulating hormones, tests to determine the amount of Estradiol and tests to determine ovarian reserve. Ultrasounds can also help assess the number of follicles in the ovaries. This test is known as an Antral Follicle Count.

Infertility caused by decreased functioning of the ovaries is usually termed as unexplained infertility. In such cases, IVF is often the most preferred form of treatment.

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