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The available eggs in the ovaries at a time are collectively called an ovarian reserve. Low reserve happens when the production of eggs reduces. This affects the chances of pregnancy. The general cause of low reserves can be aging ovaries. In such cases, the ovary may be healthy and functioning even if the reserve is low. Production of eggs lower as a woman ages. A woman starts with 250,00 to 500,000 eggs at puberty and ends up with 1000 eggs at menopause.

Causes:
Low reserves are caused by

1. Production of eggs decreases: Chromosomal abnormalities like Turner syndrome (lack of two X chromosomes) and genetic anomalies like Fragile X can decrease egg production.
2. Ovarian tissue damage: Rough torsion, endometriosis triggered ovarian cysts, malignant or benign tumours, surgical removal of ovary or any other part of it, chemotherapy or radiation, pelvic adhesions, immunological problems or high BMI (Body Mass Index) can destroy the ovarian tissues.

IVF Protocols:
If a woman has low ovarian reserves, then she will be put on the either of the following protocols:

1. Short GnRHa Flare: Gonadotrophin releasing-hormone-agonist (GnRHa) like Lupron, Nafarelin, Synarel or Buserelin is administered. This therapy is initiated at the onset of menstruation. The goal of the treatment is to stimulate the release of the follicular stimulating hormone (FSH) which augments the ovarian follicular growth.
2. Combined Clomiphene or Gonadotrophin/Letrozole Stimulation: Older women are mostly administered this protocol. But it is strongly advised not to, as this protocol can potentially harm the egg or the embryo.
3. Mid-follicular GnRH-antagonist protocol: Once the GnRHa-agonist protocol is commenced, the GnRH-antagonist is given several days later. Once the follicles reach the size of 12mm, GnRHa antagonists like Ganirelix, Orgalutran, Cetrotide and Cetrorelix are added. These drugs stop the pituitary from secreting the luteinizing hormone (FSH leads to secretion of this hormone).
4. Long GnRHa Pituitary Down Regulation Protocol: This is the usual approach to deal with low ovarian reserves.
5. Agonist/Antagonist Conversion Protocol: This protocol inhibits FSH production. This protocol generally yields good results. Consult an Expert & get answers to your questions!

Infertility is a condition wherein a woman does not get pregnant in spite of having unprotected sexual intercourse over a period of a year or even more. An abnormal menstrual cycle that is either too short or too long, irregular or even scanty can be an indication of a lack of ovulation, which in turn, is another factor behind female infertility.

Causes-

1. Ovulation disorders are characterized by either a lack of ovulation or irregular and infrequent ovulation. These are a major cause of infertility. This may be due to defects in the regulation of the reproductive hormones by the pituitary gland or the hypothalamus (brain center responsible for producing some of the most essential hormones required by the body). Malfunctioning of the ovary is another cause in itself. Polycystic Ovarian Syndrome, premature failure of the ovaries (a condition wherein a woman’s ovaries fail to function properly even before she is 40 years old), hypothalamic dysfunction (a dysfunction of the hypothalamus) and excessive production of prolactin (a hormone that stimulates milk production among women after childbirth) by the pituitary gland are some of the factors responsible for the occurrence of such a disorder.

2. Damaged fallopian tubes do not allow the sperms to fuse properly with the egg. They might also prevent the fertilized egg from entering into the uterus. This condition may be caused due to pelvic inflammatory diseases (a group of infections of the reproductive organs in women), an infection in the fallopian tubes or the uterus caused due to various Sexually Transmitted Diseases, any abdominal surgery or surgery of the pelvic region and pelvic tuberculosis.

3. Endometriosis, wherein the tissue that usually grows in the uterus, starts growing outside it, is another factor responsible for infertility.

4. Several cervical or uterine disorders, such as tumors, inflammation within the uterus, uterine abnormalities, a cervical narrowing or the inability of the cervix to produce mucous for the sperm to travel to the uterus, are likely to impact fertility by obstructing implantation or enhancing the chances of miscarriage.

Treatments-

1. Fertility drugs can be used to regulate and induce ovulation. But they carry with them certain risks and therefore you should consult your physician prior to consumption. Few examples of these drugs are Clomiphene Citrate, Gonadotropins, Metformin, Letrozole and Bromocriptine.

2. Surgical procedures can be recommended to correct reproductive abnormalities and restore fertility. A laparoscopic surgery or a tubal ligation reversal surgery (a surgery that unites one’s fallopian tubes again in order to enable the woman to have a baby) can be advised by the doctor.

3. Reproductive assistance by Intrauterine insemination (a process that involves putting sperms inside a woman’s uterus in order to help her conceive) and Assisted reproductive technology (consisting of IVF and surrogacy). Consult an Expert & get answers to your questions!

Infertility is a condition wherein a woman does not get pregnant in spite of having unprotected sexual intercourse over a period of a year or even more. An abnormal menstrual cycle that is either too short or too long, irregular or even scanty can be an indication of a lack of ovulation, which in turn, is another factor behind female infertility.

Causes-

1. Ovulation disorders are characterized by either a lack of ovulation or irregular and infrequent ovulation. These are a major cause of infertility. This may be due to defects in the regulation of the reproductive hormones by the pituitary gland or the hypothalamus (brain center responsible for producing some of the most essential hormones required by the body). Malfunctioning of the ovary is another cause in itself. Polycystic Ovarian Syndrome, premature failure of the ovaries (a condition wherein a woman’s ovaries fail to function properly even before she is 40 years old), hypothalamic dysfunction (a dysfunction of the hypothalamus) and excessive production of prolactin (a hormone that stimulates milk production among women after childbirth) by the pituitary gland are some of the factors responsible for the occurrence of such a disorder.

2. Damaged fallopian tubes do not allow the sperms to fuse properly with the egg. They might also prevent the fertilized egg from entering into the uterus. This condition may be caused due to pelvic inflammatory diseases (a group of infections of the reproductive organs in women), an infection in the fallopian tubes or the uterus caused due to various Sexually Transmitted Diseases, any abdominal surgery or surgery of the pelvic region and pelvic tuberculosis.

3. Endometriosis, wherein the tissue that usually grows in the uterus, starts growing outside it, is another factor responsible for infertility.

4. Several cervical or uterine disorders, such as tumors, inflammation within the uterus, uterine abnormalities, a cervical narrowing or the inability of the cervix to produce mucous for the sperm to travel to the uterus, are likely to impact fertility by obstructing implantation or enhancing the chances of miscarriage.

Treatments-

1. Reproductive assistance by Intrauterine insemination (a process that involves putting sperms inside a woman’s uterus in order to help her conceive) and Assisted reproductive technology consisting of IVF, which is the safest and the best.

2. Fertility drugs can be used to regulate and induce ovulation. But they carry with them certain risks and therefore you should consult your physician prior to consumption. Few examples of these drugs are Clomiphene Citrate, Gonadotropins, Metformin, Letrozole and Bromocriptine.

3. Surgical procedures can be recommended to correct reproductive abnormalities and restore fertility. A laparoscopic surgery or a tubal ligation reversal surgery (a surgery that unites one’s fallopian tubes again in order to enable the woman to have a baby) can be advised by the doctor.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Infertility is a condition wherein a woman does not get pregnant in spite of having unprotected intercourse over a period of a year or even more. An abnormal menstrual cycle that is either too short or too long, irregular or even scanty can be an indication of a lack of ovulation, which in turn, is another factor behind female infertility.

Causes:

1. Ovulation disorders are characterized by either a lack of ovulation or irregular and infrequent ovulation. These are a major cause of infertility. This may be due to defects in the regulation of the reproductive hormones by the pituitary gland or the hypothalamus (brain center responsible for producing some of the most essential hormones required by the body). Malfunctioning of the ovary is another cause in itself. Polycystic ovarian syndrome, premature failure of the ovaries (a condition wherein a woman’s ovaries fail to function properly even before she is 40 years old), hypothalamic dysfunction (a dysfunction of the hypothalamus) and excessive production of prolactin (a hormone that stimulates milk production among women after childbirth) by the pituitary gland are some of the factors responsible for the occurrence of such a disorder.

2. Damaged fallopian tubes do not allow the sperms to fuse properly with the egg. They might also prevent the fertilized egg from entering into the uterus. This condition may be caused due to pelvic inflammatory diseases (a group of infections of the reproductive organs in women), an infection in the fallopian tubes or the uterus caused due to various Sexually Transmitted Diseases, any abdominal surgery or surgery of the pelvic region and pelvic tuberculosis.

3. Endometriosis, wherein the tissue that usually grows in the uterus, starts growing outside it, is another factor responsible for infertility.

4. Several cervical or uterine disorders, such as tumors, inflammation within the uterus, uterine abnormalities, a cervical narrowing or the inability of the cervix to produce mucous for the sperm to travel to the uterus, are likely to impact fertility by obstructing implantation or enhancing the chances of miscarriage.

5. A man’s fertility generally relies on the quantity and quality of his sperm. If the number of sperm a man ejaculates is low or if the sperm are of a poor quality, it will be difficult, and sometimes impossible, for him to cause a pregnancy. Male infertility is diagnosed when, after testing both partners, reproductive problems have been found in the male.

Treatments:

Fertility drugs can be used to regulate and induce ovulation. But they carry with them certain risks and therefore you should consult your physician prior to consumption. Few examples of these drugs are Clomiphene Citrate, Gonadotropins, Metformin, Letrozole and Bromocriptine.

1. Surgical procedures can be recommended to correct reproductive abnormalities and restore fertility. A laparoscopic surgery or a tubal ligation reversal surgery (a surgery that unites one’s fallopian tubes again in order to enable the woman to have a baby) can be advised by the doctor.

2. Reproductive assistance by Intrauterine insemination (a process that involves putting sperms inside a woman’s uterus in order to help her conceive) and Assisted reproductive technology (consisting of IVF and surrogacy). If you wish to discuss about any specific problem, you can consult a gynaecologist.

Polycystic ovary syndrome (PCOS) is a disorder of the endocrine system in women. It has been found that women suffering from PCOS have enlarged ovaries. These bigger ovaries contain fluids called follicles. During an ultrasound examination, these follicles are seen. If you are suffering from irregular or prolonged menstrual periods, acne, obesity and uncontrolled hair growth, you can get yourself tested for PCOS. However, doctors have failed to determine the exact cause of PCOS. This condition can have dangerous consequences and affect the overall health of the patient. If left untreated, it can cause type 2 diabetes or heart diseases. 

What happens in PCOS? 
Women suffering from this disorder experience a hormonal imbalance in their body. The hormone changes triggers multiple issues in the body. Sometimes, body produces excess of sex hormone. Women may develop masculine features due to over-production of male hormones or androgens. There might be imbalance in insulin levels, increasing the risk of developing diabetes. 

What causes PCOS? 
Surprisingly, the exact cause of PCOS is not known. Researchers have not been able to pinpoint the exact cause for developing PCOS. However, some believe that the cause has hereditary links. 

Symptoms of PCOS 
The symptoms of PCOS are usually mild in nature during the initial stage. In the beginning, only few symptoms are detectable. These include acne, obesity, extra hair growth on face, thinning of hair on the scalp and irregular periods. The symptoms often get unnoticed by the patient first or they relate those of the pregnancy. 

Conceiving with PCOS 
In case, you have been detected with PCOS and it is the reason behind your infertility, you must not get dishearten. You have a possibility to induce ovulation. One can opt for fertility medications. These drugs have shown success in ovulation and pregnancy.

Some of these are as follows: 
1. Metformin. It helps to regulate the amount of insulin in the blood. It also helps to resolve fertility issues. 
2. Clomiphene citrate. It stimulates ovulation
3. Gonadotropins. These are known to be hormone shots, which cause ovulation. 
4. Letrozole. This drug is known to block estrogen production. Instead, it increases production of follicle-stimulating hormone. 
5. Ovarian drilling. If fertility medications fail, doctor may try doing a surgery known as “ovarian drilling.” In this method, a surgeon inserts a needle through the abdomen of the patient to destroy a smaller portion of the ovaries. This lowers the androgens produced by the ovary.

In case you have a concern or query you can always consult an expert & get answers to your questions!