Ovarian Failure – The risk of premature fatigue of ovarian function

Ovarian Failure

If it does not work out with the pregnancy, one cause of the unfulfilled desire for a child can be a so-called ovarian failure. This is an early consumption of the follicles. For an important prerequisite for regular menstrual cycles with effective ovulation is the presence of a variety of follicles in the ovary.

The original follicles are already formed during the embryonic development of the girl in the womb. With the onset of puberty, there are about 450,000 follicles left in the ovaries. The ova are embedded in the follicles. Each month, up to 1,000 oocytes are lost (atresia). This process happens unnoticed, even during pregnancy or while taking birth control pills. He is not controllable and unstoppable. How fast this natural process of follicle loss takes place is individually very different.
Premature ovarian failure – if the follicular count has dropped sharply before the 40th birthday

If the number of follicles before the 40th birthday is already greatly reduced beyond the age-commensurate extent, follicle maturation and ovulation often can no longer run smoothly. It can lead to different cycle disturbances up to the absence of menstruation. Such ovarian function limitations are referred to as premature ovarian failure (POI).

Ovarian surgery, chemotherapy, endometriosis, autoimmune diseases, or genetic predisposition may be the cause of premature ovarian failure. In most cases, the actual cause cannot be found. As follicle rumen disorders are often only relatively late despite progressive follicle loss, premature ovarian failure in the early phase often remains unrecognized. For affected women, who only want to realize their wish to have a child at a late stage, the ignorance of this situation can have serious consequences for family planning.

The progressive loss of follicles can neither be stopped nor reversed
If a premature ovarian failure is detected, there is no possibility of causal treatment. That is, the process of follicular loss cannot be stopped or reversed. New follicles or oocytes cannot develop, even through hormone treatment.

If the premature ovarian failure has occurred, active fertility treatments hardly lead to an improvement in the natural probability of pregnancy. The spontaneous chance of pregnancy, in affected women, is then only about 5%.

Preventive examination of the ovarian reserve significantly reduces the risk of premature ovarian failure
To recognize such a risk in good time, we also recommend a preventive examination of your ovarian reserve for younger women. We perform a vaginal ultrasound showing both ovaries. There should be significantly more than 10 follicles (Antral Follicle Count, AFC). In parallel, a blood test with the determination of the anti-Müller hormone (AMH) is made. The value of AMH represents the number of follicles present in the ovaries and thus the oocytes relatively reliably.

If too little follicular reserve is detected, further endocrinological and genetic investigations are initiated. In this way, we can give the affected women in good time recommendations for family planning. This may include the initiation of active fertility treatment.