WHAT IS OVARIAN AGING? CAN IT BE TREATED?

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WHAT IS OVARIAN AGING? CAN IT BE TREATED?

21/01/2021

What is Ovarian Aging? Can It Be Treated?

Ovarian Aging is one of the most researched topics. The cause has not been resolved and its treatment is being investigated by medical studies. With age, the system in our body that constantly heals and renews us pauses and starts to move backwards.

Genetically, aging is the general name of the negative structural, functional and psychological changes that occur during the natural process in our body.

With aging, the cells in our body gradually lose their ability to maintain their lives in a good way by repairing themselves.

The structure most affected by this condition is the ovaries.

In this process that starts after the age of 35, the ovaries become old and the number of eggs decreases. As a result, the chance of getting pregnant starts to decrease. Since egg quality is also affected, the likelihood of genetically defective embryos increases; this causes an increased risk of miscarriage and anomaly. Over the age of 38 this process gets even faster. (1)

 

Aging and a decrease in the number of ovaries are also seen in young women. Young women with this condition, which is often encountered even in their 20s with genetic, hormonal and environmental factors, they experience disappointment, confusion and sadness. While being treated, they also need intense emotional support.

However, in spite of this, the results of pregnancy with IVF treatment are satisfactory in young women with a low number of eggs. Despite the decrease in the number of ovaries in young patients, their quality is generally good, which makes it easier to obtain good embryos. In those who remain pregnant with treatment, the pregnancy process continues like their normal peers. (2)

 

The most important factor determining the success in IVF treatment is the age of the woman. The regularity of the menstruation does not indicate that the number of eggs is sufficient.

Although the number of ovarian reserve is low in most patients, the menstrual cycle is not disturbed. However, they apply to experts because they cannot conceive.

The decrease in the number of follicles does not indicate that the menopause process will begin immediately. Tests showing ovarian reserve are not tests used to determine the time of menopause.

By performing anti-Müllerien Hormone (AMH) and ovarian ultrasonography, the number of eggs that are candidates for growth can be evaluated together and interpretation can be made about the potential for pregnancy.

If, as a result of this evaluation made by specialists dealing with reproductive medicine, it is determined that the ovarian reserve has decreased, they warn the couples that they should wait longer to have a child and not delay.

Oosite freezing is a good option for women who are unmarried and whose number of eggs are beginning to decrease, so  they do not feel regret in the future.

The chance of pregnancy in the future is increased with eggs that are frozen until the time of marriage comes. 35-37 age range Best for oosite freezing.

Women with a family history of early menopause should be more careful about this issue.

 

Ovarian aging is associated with mitochondrial aging. Mitochondria are energy-producing structures for cells. Genetic factors, smoking, obesity, and adverse environmental conditions contribute to mitochondrial aging.

They accelerate and cause the formation of embryos with chromosomal anomalies during the fertilization process.

 

Oocyte count

Can the Number of Eggs be Increased? Can the Ovary Be Rejuvenated?

In recent years, various methods have been tried to rejuvenate the eggs.

PRP application to the ovarian tissue is performed by injecting the patient's own blood into the ovarian tissue through special procedures.

The purpose of the PRP method, which is used in many areas of medicine, is to increase the blood flow and growth factors in the ovaries. However, it is one of the experimental applications for which there is not enough evidence that it is effective.

All methods such as Invitro Activation (IVA) and mitochondria transfer, which are performed to awaken inactive, dormant cells in the ovary, are in the experimental stage and their efficacy has not been proven (6).

Studies continue for women who are approaching menopause and who desire pregnancy. Nowadays, it is possible to be successful with personalized in vitro fertilization treatments performed in months when the number and size of the oocyte are suitable for women who want pregnancy over the age of 40 and whose egg pool is severely reduced.

For couples with a 15-25% chance of pregnancy up to the age of 43, this success decreases to around 5% after the age of 43.

The Most Frequently Asked Question Before The Treatment

What kind of food should we eat? What kind of foods do our eggs turn into good quality?

Unfortunately, there is no magical food that directly affects egg quality. However, the Mediterranean type of diet is recommended as the healthiest diet. (4)

Calorie restriction and consumption of antioxidants have been shown to slow down the mitochondrial aging process (1).

Therefore, instead of magic formulas, a healthy Mediterranean diet and weight control, calorie restriction if necessary, smoking-free life will positively affect the IVF treatment and the pregnancy process we target.

 

What is the Mediterranean Type of Nutrition?

Cereals, olives, grapes, bread, pasta, olive oil, vegetables, fruits, fish, meat (in small amounts), yoghurt, cheese, legumes and oilseeds form the basis of the Mediterranean food model. Biochemical, clinical and epidemiological studies have proven that the Mediterranean diet has many beneficial effects on health. These foods are recommended not to be taken more than needed and to be consumed in a balanced way (5).

With the support of a dietician, calorie restriction is required for those who are overweight. Mediterranean type diet foods are rich in omega 3 and vitamin D.

 

As a result; We can say that the results of IVF treatment in young patients with reduced egg pool are satisfactory.

The most important factor affecting the success of IVF treatment is the age of the woman. Single women and those who do not have a marriage plan in a short time, women with a family history of early menopause should get information from reproductive medicine specialists to get information about freezing their eggs and to learn about their current situation.

The fact that should not be forgotten is' People regret more for the things they did not do and postpone later in their lives than they did. ''

Women aged 40 and over are given personalized treatment in the appropriate cycle, with an experienced team in this area.

If there is a chance of IVF, it should be tried. Also It should be known that egg rejuvenation is experimental and there is not enough evidence about its efficacy until proven positive results are obtained. In these couples who are financially and morally worn, with high expectations, fragile, looking for hope, Information and emotional support is very important.

 

Gunseli Dura Ozdemir MD

 

Obstetrics & Gynecologist

Reproductive Endocrinologist & IVF Specialist

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