Ovarian Reserve is depleting fast

Motherhood in Delhi-NCR at Stake-Study

New Delhi, April 13: It is a wake up call for motherhood in Delhi-NCR. A study by Metropolis Healthcare Limited, pathology major has come up with a shocking finding that ovarian reserve in the women of this region is depleting fast.

Baby bumps, that have been a craze in metro women, can be hard to come by in the region.

The fertility index that has emerged out of this study finds motherhood at stake in the region. The report is formulated on the basis of Anti-mullerian hormone (AMH) test for ovarian reserve, which gives a fair indication of a women’s fertility. There were 7194 samples processed at Delhi Metropolis, in which over 3193 samples ranked either low or very low in the fertility index. Overall, 44% of the women who underwent the test reported extremely low or low levels indicating fertility problems.

This test is a wake up call for those women who are delaying their motherhood for career. They must watch out their ovarian reserve, so that they can strategise their motherhood time better. This test can guide them on this score. In today’s scenario, the test comes as a boon.

The outcomes of the study are following:

Out of the7194 samples processed at Delhi Metropolis, over 3193 samples ranked either low or very low in the fertility index. Out of the7194 samples processed at Delhi Metropolis, over 3193 samples ranked either low or very low in the fertility index.

                AMH Test Result – Fertility Index

Age group in Years      Extremely low    Low Fertility      Satisfactory         Optimal          High Grand Total

21 to 25     57     271   367   690   74     1459

25 to 30     147   691   625   910   79     2452

30 to 35     276   805   438   427   35     1981

35 to 40     377   569   205   143   8       1302

Grand Total        857   2336 1635 2170 196   7194

(BiologicalReference interval:- Optimal Fertility 4.0 – 6.8ng/mL, Satisfactory Fertility 2.2 – 4.0 ng/mL, Low Fertility 0.3 – 2.19 ng/mL, Extremely low Fertility – below 0.3ng/mL; High Above 6.8 ng/mL)

Overall, 44% of the women who underwent the test reported extremely low or low levels indicating fertility problems.

Over 55% of the women in the age group 30 – 35years who underwent the AMH test reported extremely low or low levels indicating fertility problems.

Over 30% of women in the age group 25-30 who underwent the test reported extremely low or low levels of AMH.

• Commenting on the study, Dr Geeta Chopra, Head of the Laboratory, Metropolis, Delhi said “Today women marry late and plan their pregnancy in 3-5 years from marriage. Most women opt for contraception to avoid pregnancy. It is important that women understand their ovarian reserve before they take a decision on planning or delaying pregnancy. This only helps them take a better decision and avoid unnecessary stress when they plan to conceive. Having said that, AMH test is a multi-purpose test. It is a marker for predicting ovarian aging, decreased oocyte quality, potential fertility&predicts potential for successful IVF, being a prognostic marker of ovarian response in ART (Assisted Reproductive Technique). AMH is the only marker decreasing continually during the fertile life. The only marker not influenced by gonadotropin feedback mechanism. The only marker stable during the entire cycle, levels independent of menstrual cycle phase. Decreased levels predict occurrence of menopausal transition.
• Elevated levels are seen in patients with PCOS,responsible for as high as 70% of infertility issues in women who have difficulty ovulating. Studies have shown that approximately 40% of patients with diabetes and/or glucose intolerance between the ages of 20-30 have PCOS.
• AMH is also atumour marker for diagnosis & detecting recurrence for AMH producing ovarian cancer. It is a specific & sensitive marker for presence of testicular tissues in boys with cryptorchidism or ambiguous genitalia.

Infertility is growing at an alarming pace, especially in metros, says a 2012 report from the International Institute of Population Sciences. It is estimated that of the 60-80 million couples suffering from infertility globally every year, between 15-20 million are in India alone.

Female fertility is very simply defined as a Woman’s ability to conceive a biological child. A couple is considered to have fertility issues if they are unable to conceive after unprotected sex for over a year. A host of conditions affect female fertility e.g. Poly cystic ovarian syndrome (PCOS), pelvic inflammatory disease, sexually transmitted diseases, Endometriosis etc. Life style choices, hectic schedules, stress, poor eating habits are having a toll on women’s reproductive health. Today, more and more Indian women in the Metro cities are delaying their pregnancy owing to their career and competitive jobs.

While not all women may suffer from infertility problems with growing age, recent trend and analysis have a different story to tell. Today women are at a risk of infertility owing to their lifestyle choices. Thankfully science is progressing at a pace and it is possible to determine how fertile a woman is and the longevity of her fertility. This will empower women to prioritise their personal and professional lives.

The Anti-mullerianhormone (AMH)test for ovarian reserve gives a fair indication of a women’s fertility. AMH is a substance produced by granulosa cells in ovarian follicles. Since AMH is produced only in small ovarian follicles, blood levels of this substance is a measure of the size of the pool of growing follicles; which in turn is heavily influenced by the size of the pool of remaining primordial follicles (microscopic follicles in “deep sleep”). Therefore, AMH blood levels reflect the size of the remaining egg supply – or “ovarian reserve”. AMH levels do not vary significantly during menstrual cycle and can be measured on any day of the cycle.