Premature Ovarian Aging / Infertility
What is Premature Ovarian Aging?
Premature ovarian failure aging (POA) is defined as having low ovarian reserve, a low number of good quality eggs for ones age. POA is one of the major, often overlooked, causes of female infertility.
As women get older, their ovarian reserve declines. Women attempting pregnancy after age 40 often have difficulty getting pregnant because of low ovarian reserve. In some women this decline of ovarian function occurs much earlier than others, these women are considered to have premature ovarian aging (POA). POA negatively affects fertility primarily because of sub-optimal quantity and quality of eggs produced. Unfortunately, quality of eggs declines with quantity. Therefore, women with diminished ovarian reserve experience the highest miscarriage rates of any infertility diagnosis. With appropriate aggressive treatment women with POA can have their own genetic children.
Premature Ovarian Aging (POA) and Premature Ovarian Failure (POF) – What’s the Difference?
The distinction between POA and premature ovarian failure (POF) is of importance. POF is defined by an FSH level above 40 mIU/mL (post-menopausal range). Premature menopause is a term used to refer to this condition. Women with high FSH levels, but still below 40 mIU/mL are considered to suffer from POA.
Pregnancy in women with POF is a rare event. The Florida Institute for Reproductive Medicine does offer treatments to POF Medicine it is the patient who ultimately decides on treatment.
Premature ovarian aging a cause of infertility.
POA is a frequently overlooked cause of female infertility. Many physicians fail to identify POA as a cause of infertility because they use standardized ovarian reserve parameters, independent of patient age. For example, many physicians consider a follicle stimulating hormone (FSH) level under 10.0 mIU/mL as normal at all ages. This makes no sense since we know that FSH levels increasewith age. An FSH of 10 at age 20 means something very different then the same FSH level at age 40. Effective treatment of low ovarian reserve starts with diagnosis. Timely diagnosis is crucial because once the ovarian reserve begins to decline it continues to decline. A diagnosis of POA is reached when age-specific FSH levels are too high. In recent years anti-mullerian hormone (AMH), especially in younger women, has proven a better predictor of ovarian reserve than FSH. While very low AMH levels have been associated with low pregnancy rates, women even with undetectable AMH levels can still conceive and have healthy pregnancies.
Treatment of Premature Ovarian Aging
The Florida Institute for Reproductive Medicine employs aggressive IVF stimulation protocols frequently in combination with growth hormone to improve chances for pregnancy. We have had very encouraging results with the addition of growth hormone with POA patients undergoing IVF. The Florida Institute for Reproductive Medicine offers a package of three IVF cycles and any potential cryo IVF cycles at a highly discounted cost to allow POA patients to be able to have multiple embryo transfers if necessary.