Ovarian egg reserve, often referred to as ovarian reserve, is the term used to describe the number and quality of a woman’s remaining eggs. Every woman is born with a fixed number of eggs, and this reserve naturally declines with age. Unlike men, who produce sperm throughout life, women do not create new eggs. The number of eggs is highest at birth and continues to decrease over time, especially after the age of 35 (Wikipedia).

Ovarian reserve is a key indicator of reproductive potential and is often assessed when planning pregnancy or evaluating fertility concerns.

Why Ovarian Reserve Matters

Ovarian reserve plays a central role in female fertility. It helps determine:

• How easily you may conceive

• How well you may respond to fertility treatments like IVF

• How much time you may have left to try for pregnancy

• Whether options like egg freezing should be considered sooner

A low ovarian reserve does not necessarily mean pregnancy is impossible, but it may mean fewer eggs are available and reduced chances of natural or assisted conception.

What Causes a Decline in Egg Reserve

Egg reserve naturally declines with age, but several other factors can contribute to early or accelerated depletion:

• Age – The most significant factor; decline becomes more noticeable after age 35 and accelerates after 38 (PubMed)

• Genetics – Some women are born with fewer eggs or experience early menopause

• Lifestyle – Smoking, poor diet, high stress levels can negatively affect ovarian function

• Medical treatments – Chemotherapy, radiation, or ovarian surgeries can damage egg-producing tissue

• Health conditions – Endometriosis or autoimmune diseases may impact ovarian reserve

How Ovarian Reserve Is Measured

Fertility specialists use a combination of ultrasound and hormone tests to evaluate ovarian reserve:

• Antral Follicle Count (AFC)
  Conducted via transvaginal ultrasound to count small follicles in the ovaries during the early cycle. A higher count usually indicates better reserve.

• Anti-Müllerian Hormone (AMH)
  Measured via a blood test, AMH reflects the number of growing follicles and remains stable throughout the menstrual cycle (Cleveland Clinic — AMH Testing).

• Follicle-Stimulating Hormone (FSH)
  Tested on cycle day 2 or 3. Elevated FSH, when paired with low estradiol, may suggest diminished ovarian reserve (ASRM).

Can Low Ovarian Reserve Be Improved

Ovarian reserve cannot be increased, as women are born with all the eggs they will ever have. However, certain strategies can help optimize egg quality and support fertility outcomes:

• Early fertility planning, particularly before or around age 35

• Personalized IVF stimulation protocols based on ovarian response

• Lifestyle changes such as quitting smoking, improving diet, and managing stress

• Egg freezing when egg quality is still strong

While various supplements, hormones, and experimental therapies are sometimes used to support egg health, most remain unproven in large-scale clinical trials. According to a 2022 review, many modern ovarian rejuvenation treatments, including platelet-rich plasma and stem cell therapy, are still investigational and not standard of care (NIH – Emerging technologies in fertility preservation).

When to Get Tested

Consider ovarian reserve testing if any of the following apply:

• Over 30 and delaying pregnancy

• Attempting to conceive for 6–12 months without success

• Family history of early menopause

• Planning for IVF or egg freezing

• Facing medical treatments harmful to fertility

Testing is minimally invasive and provides actionable insights for fertility planning.

Summary

Ovarian egg reserve reflects the number and viability of eggs remaining in the ovaries. It declines naturally with age and can be affected by genetics, health, and lifestyle. Although the reserve cannot be restored, early assessment empowers women to make informed decisions about fertility strategies.