Women are born with a certain number of eggs and IVF stimulation of ovaries to produce extra eggs in
single menstrual cycle might logically let your ovarian reserve exhaust and push
you enter early menopause!
Normally, women with menstrual cycle length between 28 to 30
days ovulate 12 times/year producing one egg for every cycle. So, she uses only
12 eggs per year. However, one IVF cycle
demands the harvest at least 15 eggs or more for one IVF cycle through stimulation
of ovaries with hormones, so as to make use of best few eggs.
Now, multiple IVF
cycles (in case of recurring failure) might make use of dozens of eggs.
Mathematically, the ovarian reserve of women undergoing the above process
should deplete than normal and she should find herself standing on the last
leap of her menstrual cycle, staking her long-term fertility.
However, the laws of medical logic annul all such absurd facts.
Scientifically, ovaries are the pair of egg reservoirs situated in pelvic
region of women. Eggs are the cells which are also called genetic blue prints
that create babies with male sperm. Ovaries have specialized structures called
follicles to store, protect, and nourish eggs.
Between 18-22 weeks of gestation, a female fetus contains about 2,000,000+ follicles in its ovaries and each follicle contains one egg. However, the fetus loses 80 % of its eggs at the time of birth and it is left with only approx 3,00,000 eggs in her ovaries. From puberty to menopause, she loses almost all her follicles. During her lifetime menstrual cycle, a woman normally ovulate around 400 eggs, releasing one mature egg each month.
Most of the immature follicles inside ovary do not mature to
release eggs. So, around 99.99 % follicles do not serve any biological purpose
by not releasing eggs.
How ovary functions during menstrual cycle?
With the start of menstrual cycle, the pituitary gland
secretes Follicle Stimulating Hormone (FSH) to stimulate the ovarian follicles. In
response the follicles start growing and out number of follicles one follicle (called
dominant follicle) carries the mature egg. This mature egg is released during
ovulation. Meanwhile, the other follicles which fail to mature are lost in the
process. These follicles die in a natural process called atresia.
How ovary functions during IVF?
During IVF, women are injected with high amount of FSH, higher
than the body normally produces. High FSH matures higher number of follicles to
produce potential eggs in single cycle.
This is done to retrieve maximum number of eggs in one cycle for embryo
formation.
This is the reason why IVF treatment will not deplete your
ovarian reserve because, the stimulation matures the follicles which would
otherwise die. This is why the IVF
treatment does not cause premature menopause. Even if you have multiple IVF
cycles, it would not affect your ovarian reserve.
However, the other parallel truth is infertile women have
higher risk of early menopause because of already poor ovarian reserve. It is
due to the biological functioning of their bodies and it has nothing to do with
IVF or number of IVF they are subjected to. So, if you are infertile and you
enter menopause after IVF then please understand that it was not IVF which
exhausted your ovarian reserve. You would have entered early menopause anyway,
even without undergoing IVF.
Dr Neeraj Pahlajani
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