Diminishing ovarian reserve (DOR) is a phenomenon that affects a woman’s ability to get pregnant – both naturally and with advanced fertility techniques (ART). As women age, ovarian reserve and egg quality decline. It’s normal and natural, but this process of ovarian aging is a cause for concern among many women nearing the end of their reproductive years.
At Collaborative Care, we hear way too often from patients who say they were told they can’t, or won’t get pregnant with their own eggs. Even if it’s not what their physician intended, it’s what they heard, and unfortunately, believed….
I wish the conversation could be less anxiety provoking, more patient-focused, offering positive guidance with integrative care in mind. I believe we owe women the best, most effective care possible during the remaining time they have left to use their own eggs. Integrative care can often be recommended a little too late; the couple has endured the stress of weak IVF results and/or miscarriages. They are discouraged, and lacking the motivation to keep trying; they may decide to use donor eggs.
This is not about whether donor eggs are better for women with DOR. It’s about understanding the process for those with waning egg quality and reserve and presenting them with viable options in a positive, hopeful way.
Women nearing the end of their reproductive years can get pregnant and have healthy babies. They also can miscarry more often due to chromosomal issues. However, presenting options in an open, honest way can help women and couples navigate this already stressful time with much less added fear and anxiety.
Chinese medicine is a viable option. Chinese medicine can also be a stand alone medicine for cases of DOR, or at the very least integrated as part of an ART treatment plan well before the woman begins any medications.
Here is why. First, IVF is generally best for women who have sufficient ovarian reserve. These women respond better to the high doses of gonadotropins given during controlled ovarian stimulation; generally speaking they have a better number of follicles that grow at the same rate and therefore have more mature eggs come the time of retrieval.
A woman with DOR often responds with lead follicles that dominate the cycle and result in overly ripe follicles and immature eggs at retrieval. It’s not only about producing a lot of eggs, the growth and maturity of the follicles are extremely important.
In this scenario, women respond better to their own, natural follicular recruitment and maturation, or to gentle, smaller dose stimulation protocols. The holistic mechanisms behind Chinese medicine benefits the reproductive system by supporting and strengthening the ovarian response, balancing hormones, increasing blood supply to the ovaries and creating a better follicular environment for eggs to develop and mature.