“The quality is related to the age of the woman”

This week I had the pleasure of talking to Dr. Marta Colodrón from Barcelona IVF about how to deal with premature and low ovarian reserve, or primary ovarian insufficiency (POI). But first, what is it?

In general terms, POI is when a woman’s egg supply is low and, therefore may not release an egg each month as it should, making it harder to get pregnant. However Marta was quick to tell us that this does not necessarily mean you will need fertility treatment as it is not the same thing as the menopause.

Marta told us that what we should really be focussing on is the age and quality of the eggs; “The quality is related to the age of the woman” Marta said. “If we have ten patients, all aged 36, and two of them have low ovarian reserve with an AMH level under one. We know those patients are more likely to have problems to get pregnant, but we cannot say the woman is infertile because we have reported natural pregnancies, even with a low AMH level.”

In terms of quantity verses quality, Marta said she would prefer to get three {eggs from a woman under 35 than nine eggs from a woman aged 42, because the age and quality of the eggs.  Her advice being that, if you have a partner and know your reserve is low, to start trying to get pregnant naturally as soon as you can, to avoid fertility treatment.

I asked Marta if she thought the reason more women were experiencing POI was down to a lack of knowledge. As many leave it later to start their family, then come across a diagnosis of POI, it’s harder to get pregnant naturally.  I asked if we should be screening women earlier on, so we have an idea of what’s going on before it’s too late. “I would say if your mother or grandmother had problems, or if you suspect endometriosis, then yes.”

50% of women with endometriosis tend to need ART (assisted reproductive technology) to get pregnant. Marta believes that doctors need to do a better job of identifying female health conditions, to best prepare women for the fertile future; “It shouldn’t be give the pill to all the teenagers who have painful periods. No, I think that we need to try to do better our job and try to identify the situation.” For example, if a young woman, whose mother had endometriosis, and there is a pattern emerging with painful or heavy periods, Marta suggests to check the AMH level and “not just give her the pill. You can give her the pill, of course, but maybe you need to check the AMH level and maybe if she doesn't have a partner or a project of getting pregnant in a few years, to then freeze her eggs.”

But with regards what to do about low ovarian reserve, when it comes to regeneration or ‘fixing the problem’ the options are currently limited; “We are trying  platelets (PRP or platelet rich plasma) but it's still very exploratory. We are doing the studies, but we don't have great results.” However Marta is more positive about the future of stem cells; “From a stem cell we can try to create one egg and probably we will get there in a few years. Like they are making pancreas cells for the diabetics. If we can create cells that produce insulin from the pancreas and we don't need to give insulin, that will be perfect.  Similar with the eggs. If we can create eggs from the stem cells, that will be the option.”

For more information about PRP and future technology, join us for our free conversation entitled "New advancements - genetic testing and PRP explained” on Wednesday 15th November at 1pm on Let’s all Talk Fertility.  But before that, we shall be discussing male fertility on Wednesday 1st November - get your FREE ticket here now: TICKETS