World Ovarian Cancer Day 2021: Experts shed light on understanding ovarian reserves

Women have a pair of glands called the ovaries, and eggs can form embryos when fertilized with sperm. Throughout life, the ovaries help maintain levels of various hormones, such as estrogen and progesterone, which are key to maintaining homeostasis. However, organs are also susceptible to diseases such as cancer. Ovarian cancer rarely shows major symptoms. This can lead to delayed diagnosis and therefore can cause complications during the treatment process.

World Ovarian Cancer Day will be held on May 8th to raise awareness about organs and diseases. Similarly, delve into ovarian reserve, how it is an important indicator of childbirth, and what aspiring mothers with ovarian cancer can do to maintain their childbirth.

What is ovarian reserve?

Simply put, ovarian reserve is the number of viable eggs present in the ovary at a particular time. A pair of ovaries is a major organ of the female reproductive system involved in the production of the ovaries, also known as “eggs”. Women are born with about 1 million immature eggs or follicles. The prepubertal ovary is a long bundle of tissues that resides in the body. They grow older and mature over time. By the time a woman becomes sexually mature, the number of ovarian follicles is reduced to about 300,000. The number of follicles continues to decline gradually until a woman reaches the age of 35, after which it drops sharply.

As we get older, the number of eggs that can be fertilized by a woman decreases, highlighting the inverse relationship between age and the fertilization rate of a woman. It is not only the quantity that decreases with the age of the mother, but also the quality of the eggs. Ensuring a healthy lifestyle by checking your physical and mental health can help you expand your window. Natural conception can be difficult if the quality and quantity of eggs are not appropriate.

How can I check my ovarian reserve?

There are several tests available that can assess a woman’s fertility or ovarian reserve. This can be done by counting the number of eggs present or by estimating hormone levels based on their amount. Women can be tested for follicle-stimulating hormone (FSH) and anti-Müllerian hormone (AMH), or clomiphene citrate. These are all hormone level tests. Ultrasound is an imaging technique that allows you to assess the number of follicles, that is, to determine the number of viable eggs and to test your response to hormone therapy such as gonadotropins. These tests can also help diagnose diminished ovarian reserve or DOR. This occurs when a woman’s ovaries lose fertility and cause infertility. DOR is commonly observed in women approaching menopause, but the rate of decrease varies from case to case. DOR can also be caused by genetic abnormalities, ovarian surgery, lifestyle factors, aggressive treatment and injury, and can be idiopathic.

The results of these tests will help professionals determine the appropriate treatment and dosing regimen for successful conception. There are no clear treatment options available to treat or reverse DOR, but it is advisable to conceive with assisted reproductive technology (ART) such as in vitro fertilization (IVF).

Birth of a patient with ovarian cancer

The techniques of giving birth to people with ovarian cancer vary from person to person. This depends on the type of cancerous cells, when the disease was detected, how much it spread to either or both ovaries, and the treatment proposed. If the disease is detected early, egg freezing is a champion technique that can protect the eggs that can be collected before starting treatment such as chemotherapy. Alternatively, modern medicine has found a way to develop a primitive and basic entity, the germ cell, into an egg. Eggs obtained by these methods can be used by women themselves after the disease has been overcome. IVF is essential here.

If the prognosis progresses, the uterus can also be damaged, resulting in surgical resection of the ovaries and uterus. Surrogacy is useful here.

Regardless of the extent of spread, it is imperative that women with ovarian cancer discuss their aspirations and maternal dreams with their doctors.

About the author: Dr. Kshitiz Murdia, CEO and co-founder of Indira IVF

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