I have patients who were scared of their high FSH or low AMH level. I always ask them, “did you just have IUI/IVF?” Some even has menopause sign – hot flashes. If they just had IUI/IVF medication, then it is not likely their nature ovarian reserve degraded.
I feel the following statement from Shady Grove Fertility website is not correct or at least partially not right.
“Some women are concerned that using several eggs in a single cycle may prematurely deplete their ovarian reserve and cause an early onset of menopause. Women are born with all of the eggs they will ever have, around 1 million. By the time they reach their first menstrual cycle there are approximately 400,000 eggs remaining. Retrieving several eggs at any given time will not cause women to use all of their remaining eggs or develop an early onset of menopause.”
In the website of government NIH, they clearly states IVF medication can affect ovary reserve.
Implications of using follicle-stimulating hormone preparations … – NCBI
https://www.ncbi.nlm.nih.gov/pubmed/9526704
https://www.ncbi.nlm.nih.gov/pubmed/28188844
by SL Regan – 2017 – Cited by 1 – Related articles
Feb 7, 2017 – Infertility and ovarian follicle reserve depletion are associated with … in Australia (5.8%) undergoing IVF (5.8%) is linked to the depletion of the …
Considering other factor unchanged, the number of follicles entering antral stage is limited or has certain output rate. While antral follicles which is hormone medicine responsive has 65 days to enter dominate follicle selection. Therefore, any speeding using hormone medication like Clomaid, Gona-F and menopur, etc will causing the rest of antral staged follicle depleted. The more IVF cycles, the more depletion it is. And also the quality of follicle will be lowered. It is the simple of maths.
Based on the fact of Folliculogenesis, I recommend patient patients to wait at least two menstrual cycles to get their antral follicle pool replenished. Or at least try nature IVF or mini IVF which harvest only one or two follicles especially for those advanced age patient or low ovarian reserve(LOR) patients.
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