A disturbing phenomenon of low ovarian reserve is being seen in young women in their early 20s and 30s, indicating that the rate of infertility in younger women is on a rise in the country.
Recent studies carried out in the Institute of Genetics and CCMB after collecting samples from various hospitals in different cities have shown that that almost 4 per cent of the women diagnosed had low ovarian reserve and of them 37 per cent were under 30 years of age and 87.5 per cent were under 35 years of age.
The average rate of infertility in India is 10 per cent for multiple reasons — that means a 30 million infertile couples in the country.
What is low ovarian reserve?
Low ovarian reserve means that there are small number of eggs in a woman’s ovaries. Every menstrual cycle releases eggs and the stock gets over by the time the woman is in her mid-20s or 30s. The reserve of eggs is affected negatively due to environmental factors, exposure to chemicals and also genetic reasons. But a low reserve means that the eggs reach a zero status in a younger age.
Many women plan their pregnancies in their mid-30s. These women then require donor eggs. This is a very emotionally devastating state for them.
Difficult to nail the problem
The increasing trend in the last 10 years has brought an alarming increase in cases of Premature Ovarian failure but at the same time made it difficult to pinpoint the exact reason. Researchers working on it believe that there is no concrete reason but find that multiple factors in the environment and lifestyle are responsible for it. Changing food habits, work cultures with increased pressure and high stress jobs are also some of the reasons.
Dr Saroja Koppala, Fertility Consultant, Nova IVI Fertility, said, “There is an increase in the incidence of smoking in women which is one of the reasons. Smoking accelerates loss of ovarian follicles, which affect the reserves. Some of them are also exposed to toxins during their everyday travel. Dealing with pesticides directly at home level without taking proper precautions also is found to damage the system. Adulteration in food also plays a major role.”
Apart from this, premature ovarian failure is also caused by genetic causes like autoimmune disease and metabolic disturbances which have a direct impact on the reserve and deplete it faster than required.
Only a fixed number of eggs
Every woman is born with a fixed number of eggs which is on an average 1 to 2 million. As she ages, the number of eggs keeps declining. The optimum age for fertility is up to 30 years. After that there is a significant decline in the quality and the number of eggs.
Dr G. Preethi Reddy, fertility specialist at Rainbow Children’s Hospital, said, “The more advanced the age, the more unhealthy the eggs. By the time a woman becomes 37 years old there is a sharp decline in the number of eggs and also the chances of getting pregnant. By 40 years, spontaneous pregnancy is only in 5 per cent of the cases and the remaining 95 per cent require help from fertility clinics.”
With chronological ageing, there is also biological ageing of the ovaries. Hence planning pregnancy after 35 years of age leads to difficulty in getting pregnant. Also, risks of miscarriage and increased risk of chromosomal problems in the baby is very high.
Alarming figures
In 2005, cases of premature ovarian failure were rated at just over 1 per cent but in 2015 it has gone up to 7 to 8 per cent. Factors causing it are chromosome problems like Turners syndrome, Fragile X syndrome, autoimmune cases, metabolic causes like cancer treatments — radiotherapy and chemotherapy.
Obesity
Women who have very short menstrual cycles or are suffering from polycystic ovarian syndrome.
