The number of eggs is predetermined for every individual at birth and they wait in the ovaries until puberty. With puberty, a group of eggs is activated every month, and only one of them matures and ovulates, while the others are discarded before they can mature. This is a recurring monthly occurrence, and thus the number of eggs a woman is born with decreases and eventually reaches zero at menopause, ending the ovulatory function. Some individuals are born with a lower number of eggs; therefore, their ovarian capacity is depleted earlier than their peers.
Ovarian capacity is shaped while a baby is in the mother’s womb. Eggs begin to form while still in the womb, and any negative conditions during that period can affect this process. New egg formation does not occur after birth. In other words, the foundation of ovarian capacity is actually laid while in the mother’s womb. Consequently, there is no known method today to increase ovarian capacity. However, there are factors that have a negative impact on the quality of existing eggs (such as smoking and obesity), and it is possible to improve egg quality by balancing these factors.
How is early ovarian capacity reduction detected in women?
This condition, which is occasionally suspected due to irregular periods, is mostly seen in women with regular menstruation. While periods remain regular, the amount of bleeding and the number of days may decrease. Therefore, it does not have a standard finding or symptom. We generally observe that the number of follicles, namely the sacs containing eggs, in the ovaries is low during ultrasonography. Subsequently, we confirm the decrease in ovarian capacity with certain requested blood tests (such as FSH, E2, AMH). When we detect this condition, we warn our patient that they may experience difficulty in having children and advise them to accelerate the process of having children and not to postpone it. If the woman is not married or requires time to have children for other reasons, we recommend freezing her eggs. Thus, it will be possible to preserve the existing eggs by freezing them. In the future, these eggs can be thawed to have a baby through IVF treatment.
Underlying genetic (chromosomal) problems or immune system diseases may play a role in early ovarian capacity reduction. It is possible to investigate these causes with blood tests. Genetic tests must be performed especially for women who experience early menopause under the age of 30. If there are female family members who entered early menopause, these women are also in the risk group for early ovarian failure; it would be beneficial for them to share this information with their physicians during regular gynecological examinations. In immune system problems, early ovarian capacity reduction, thyroid problems, and some other immunological diseases we call autoimmune can occasionally be seen together, and appropriate treatment may need to be started for these women. It is important not to delay the necessary treatment for these women to improve their quality of life.
