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Posted on 03/20/2019 in Integrative Understanding of Infertility

Ovarian reserve and fertility

Ovarian reserve and fertility

Ovarian reserve and fertility are synchronized in ideal tandem. Higher your ovarian reserve, the more fertile you are. But what is “ovarian reserve” and how does the “ovarian workflow” synchronized with fertility?

The gender generation event is synchronized with fertilization!

The gender can be known in the moment of fertilization! The spermatozoon that penetrates the oocyte and fertilizes it. It's also responsible for “generating” your baby's gender! Gender generation event is launched at the moment of fertilization.

Gender chromosomes: what are they?

Every oocyte has only an X sex chromosome. This is the only sex chromosome that is “launched” in oocyte’s genetic content. On the contrary, every spermatozoon carries either X sex chromosome or Y sex chromosome. Most secure authentication with the gender ID ever! Amused? So do I!

Most secure authentication with the gender ID ever! 

If the oocyte is fertilized with the spermatozoon that carries X–chromosome content, the embryonic content will be “XX”, and you should expect the lady–bundle in nine months! If the spermatozoon’s content has a Y–chromosome, the embryonic content will be “XY”, and you should expect the dude–bundle in nine months!

Ovaries’ generation event happens when your fetus–lady is only 11–12 gestational weeks old!

So if you have a lady–bundle, the ovaries generation event happens during 11–12 gestational week. From this timeline, there are more than 4 million oocytes in her ovaries, and this number is growing till 20th gestational week! Tiny ovaries have so powerful ovarian reserve!

Your miniature “newborn” has a STUNNING ovarian reserve! Largest ovarian reserve ever.

Ovarian reserve is designed when your fetus–lady is only 13 gestational weeks old! Every week, your lady–bundle’s ovarian reserve is growing and growing! So tiny! So powerful! Your tiny fetus–lady has more than 6 million oocytes in her ovaries being just 20 gestational weeks old!

But her ovarian reserve will be decreasing starting from 20th gestational week… Most of her oocytes will disappear.

Did you know that the newborn baby girls are born with limited ovarian reserve? 

When she is born only 2 million oocytes will be there, the rest will just disappear from her tiny ovaries. Your newborn little lady appears with “launched ovarian reserve” that will decrease to 1 million oocytes by puberty. And every month the young lady loses more than 1 oocyte. Actually, nearly 1000 oocytes are lost in total.

Every month, usually, there is only one oocyte’s release

The oocyte release is termed as ovulation. The ovulation timeline is the most fertile timeline ever in your cycle. The most brilliant Debut of the oocyte ever. Every month one mature oocyte is released from the ovaries. But it has never ever released “alone.” The oocyte release event involves also the oocyte death event. Every month, the young lady loses nearly 1000 oocytes (sometimes even more) that face spontaneous death event. This number is constantly increasing with the lady’s age.

What is “oocyte”?

An oocyte is the female’s gamete cell that is exclusively designed in her ovaries and has genetic content. The oocyte has the largest interface ever. If you could glance at the oocyte under the IVF micromanipulator workstation, you would have noticed that it is like a sparkling diamond jewel. The visualization under the powerful microscope makes it possible to see how authentic the oocyte is!

The “sunburst interface” of the follicular surrounding the cells turns it into the most secure “chip” ever. The follicular surrounding the cells create the most “secure high–tech authentication system” talk about efficiency! They literally secure the oocyte and prevent it to be fertilized by the millions of sperm cells.

The “dual–penetration–control system” “launched” in every oocyte consists of several layers of somatic cells termed corona radiata. Corona radiata has the most secure authentication system ever. It interacts with every spermatozoon that tries to penetrate inside and fertilize the oocyte and secures the oocyte from spontaneous penetration.

Only one spermatozoon will be chosen and will get the chance to penetrate and fertilize it. It will be ideal in everything: ideal vitality, ideal morphology & ideal content. It will penetrate through the corona radiata layer and zona pellucida. Here, the close interaction of the oocyte’s genomic content and spermatozoon’s genomic content designs the embryo. Brilliant. In every way. 

After fertilization, the oocyte launches more secure anti–penetration system that makes it absolutely impossible to penetrate inside it again. Its envelope installs the cutting–edge “system” that secures it with 100% accuracy. Diamond dual–control anti–penetration system is turned on. Authentic. Ideal. efficient. In every way.

Envisioned or nope, every time after the “love event”, millions of sperms are trying to reach it but most of them will die. Ultimately, only one spermatozoon will be “chosen” by the oocyte to fertilize it. The rest will face inevitable death.

Ovarian reserve profile

Young ladies (under 13 years old) have their ovaries full of oocyte follicles, waiting to mature. The “waiting period” is “completed” when the first period begins. From this time, during each period, a certain number of oocyte follicles are activated (activation mode is turned on) to prepare for ovulation but only one oocyte takes the center stage to mature and be released from the ovary.

Only one diamond–jewel will have its most brilliant debut. This Brilliant oocyte’s debut is synchronized with the oocyte loss event. Every month the young lady loses around 1000 follicles. And this number grows with her age.

Ovarian reserve synchronized with woman’s age (statistics)

Fetus bundle — 6–7 million oocytes (6–7 million eggs in her ovaries);

Newborn bundle — 1–2 million oocytes (1–2 million eggs in her ovaries);

Under 20 years old — 400,000–800,000 oocytes (400,000–800,000 eggs in her ovaries);

Under 25 years old — 200,000–400,000 oocytes (200,000–400,000 eggs in her ovaries);

Under 30 years old — 100,000–200,000 oocytes (100,000–200,000 eggs in her ovaries);

Under 35 years old — 75,000–100,000 oocytes (75,000–100,000 eggs in her ovaries);

Under 40 years old — 50,000–70,000 oocytes (50,000–70,000 eggs in her ovaries);

Under 45 years old — 10,000–20,000 oocytes (10,000–20,000 eggs in her ovaries);

Women face infertility issues when their ovarian reserves are empty.

Ovarian reserve tests: what are they? 

There are two tests that may answer your questions about your ovarian reserve: an ultrasound–guided antral follicle count and an AMH (anti–Müllerian hormone) blood test.

An antral follicle count test is a non–invasive procedure that is done via transvaginal ultrasound. The ultrasound scan visualizes how many follicles are there and the OB–GYN, or Reproductive endocrinologist counts visible follicles sized 2 mm–10 mm. These visible follicles have in their content an immature oocyte that may potentially mature & ovulate. This ovarian reserve test is done to show how many morphologically healthy follicles are there, and how many oocytes may be retrieved and collected for egg freezing or IVF cycle. Usually, it is performed before the period cycle.

This test doesn’t show the approximate number of the oocytes left in your ovarian reserve.

On the contrary, AMH (anti–Müllerian hormone) blood test is done to estimate the number of follicles inside the ovaries and an approximate number of the oocytes left in your ovarian reserve. Anti–Müllerian hormone is an authentic glycoprotein produced by granulosa cells of preantral & tiny antral follicles that are “launched” in the ovaries. This hormone is “injected” in the blood flow. The anti–Müllerian hormone concentrations in blood show the number of follicles that are inside the ovaries.

The lower your anti–Müllerian hormone concentrations are, the lower your ovarian reserve is:

Low ovarian reserve — ≤1 ng/ml (less than 1 ng/ml anti–Müllerian hormone concentration);

Normal ovarian reserve — 1–4 ng/ml (1–4 ng/ml anti–Müllerian hormone concentrations);

High ovarian reserve — ≥4 ng/ml (more than 4 ng/ml anti–Müllerian hormone concentrations);

IVF cycle or IUI cycle: what bundle to choose? 

Ovarian reserve tests are performed prior to any IVF or IUI cycle is designed. Women with low ovarian reserve are usually proposed to have the individualized IVF cycle with ICSI to boost their chances of getting pregnant. Women with normal or high ovarian reserve may choose IUI as an alternative option.

Low ovarian reserve & fertility preservation (egg freezing / oocyte cryopreservation / oocyte vitrification)

If there is a low ovarian reserve mode, the OB/GYN or Reproductive Endocrinologist may recommend you to undergo egg freezing cycle if you would love to be a mom later. Egg freezing cycle is designed to preserve the oocytes for the future fertilization and embryo transfer.

Conclusive words about ovarian reserve & fertility

Ovarian reserve is designed on a fetal stage. And it is limited. Every month the ovarian reserve is diminishing. Longitudinal investigations show that the oocyte generation event is ideally synchronized with the follicle loss event.

Every month when the diamond jewel has its brilliant debut, 1,000 follicles “face” the spontaneous death. Ovarian reserve management is an ideal tool to “visualize” your fertile timeline and to preserve your fertility. Ovarian reserve tests, performed in tandem, are the most accurate statistical visualizers of your ovarian reserve

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