One significant aspect of fertility is the wife’s egg reserve. We must know the fact that Egg reserve in a female is  limited. At the onset of puberty one egg matures and is released out every month. This process goes on till about 45-50 years of age after which all the eggs get depleted. Unlike certain other organs like skin where new cells develop as the old ones die out, this does not happen n case of female eggs. So  a woman who has delayed pregnancy for some reason, the challenge is to obtain good eggs when she actually starts planning pregnancy . Moreover in some patients, the egg  reserve is low to start with and the process of depletion of eggs is also accelerated hence they land  up with low egg reserve as a major factor in their pregnancy planing.

Most often such couples are advised IVF/ICSI treatments early in the treatment phase. At times in fact they are not even offered treatment with self eggs, and have to resort to Donor eggs.

Kajal was a 32 year old working woman now settled in the US with very poor ovarian reserve, her tests  including AMH were very low , levels below 1.5. She and  her husband had been planning pregnancy for past 3 years and all the other reports were absolutely fine. She visited many IVF clinics and many turned her away saying Donor egg was the only option. She underwent a self cycle too, unfornunately, there were no embryos formed. She was devastated. She came to us, but was determined to have her own biological offspring. We did her basic evaluation and few additional tests. Pre planning was done and she was put on hormonal medications for 3 weeks prior to her cycle. Soft stimulation protocol was used and we had 3 embryos formed. These were frozen on the 3rd day. Pre IVF medications were repeated and she underwent second cycle  in which we has good 3 embryos as well. Subsequently one month gap was given and then she was started on on Estrogen pills to form uterine lining . After 15 days
when the lining was ready , she was given progesterone injections and the embryos were thawed and
transferred . She is very happy to get a positive pregnancy .
One should not leave hope if the egg reserve is low , there are means and ways to optimise the
treatment and get good results .