poor ovarian reserve:

New Genetic Test Predicts Better Egg Production for Women with Poor Ovarian Reserve, Study Shows

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March 19, 2012 (New York, NY) – A genotype of the FMR1 (fragile X mental retardation) gene preserves a woman’s ability to produceCHR eggs (oocytes) well into the 40s, according to an ovarian aging study just published in the medical journal PLoS One1.

Conducted at the Center for Human Reproduction (CHR), a fertility center in New York City specializing in fertility treatments for older women, the study compared egg yields during in vitro fertilization (IVF) in women above age 40 with varying FMR1 genotypes and sub-genotypes.

In women with very poor ovarian reserve (i.e., women with the poorest ovarian function), the FMR1 sub-genotype het-norm/high (normal CGG repeat count on one allele, abnormally high count on the other) produced significantly more eggs than other genotypes and sub-genotypes. This observation suggests that the het-norm/high FMR1 sub-genotype preserves a woman’s ability to produce a good number of eggs at older ages even if the ovarian reserve is severely reduced.

“From our previous research, we knew that the het-norm/high sub-genotype was responsible for slow recruitment of eggs into maturation process at younger ages than other genotypes and sub-genotypes,” explains Norbert Gleicher, MD, lead author of the study and Medical Director of CHR. “Because these women ‘use up’ fewer eggs from their egg reserve, we suspected that they may have more eggs left when older. This study confirmed this hypothesis, demonstrating that women with this sub-genotype performed better in IVF cycles than even women with normal FMR1 genotype.”

These findings further enhance the understanding of genetic control over the process of ovarian aging, and further refine prognostication in older women undergoing fertility treatments. Given that oocyte yields in IVF cycles usually correlate with pregnancy chances, older women with extremely low ovarian reserve, therefore, appear to have better chances of success if their FMR1 sub-genotype is het-norm/high.

 

1Gleicher N et al. The impact in older women of ovarian FMR1 genotypes and sub-genotypes on ovarian reserve. PLoS One 2012:e33638. [http://dx.plos.org/10.1371/journal.pone.0033638]

 

About Center for Human Reproduction

Center for Human Reproduction, or CHR (http://www.centerforhumanreprod.com), is a leading fertility center in the United States with a worldwide reputation as a “fertility center of last resort,” specializing in treatment of infertility in women with diminished ovarian reserve, including younger women with premature ovarian aging (POA) and older women with physiological ovarian aging. Dr. Gleicher is available for additional comments.


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What Does High FSH Mean?

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Abnormally high FSH (follicle-stimulating hormone) as reflected on a blood test could mean that your ovaries do not have a sufficient amount of eggs for normal reproduction, a condition also known as poor ovarian reserve.

What is FSH?

FSH is a hormone produced by the pituitary gland which helps regulate the female reproductive process in the body. When a woman is born she already has a finite number of eggs stored in individual pockets of her ovaries called ovarian follicles. When she reaches reproductive age FSH is released each month in order to stimulate these follicles to prepare a single egg for ovulation.

Why is High FSH Bad?

A woman’s body has a special feedback mechanism which controls the amount of FSH that is being made. Often times when a woman goes through menopause or premature ovarian aging – two conditions in which the ovaries no longer have a sufficient amount of eggs available for reproductive potential – this feedback mechanism fails. Once this fails, uncontrolled amounts of FSH are produced by the pituitary gland. Therefore, health professionals consider high FSH levels a strong indicator that a woman likely has poor ovarian reserve. Poor ovarian reserve is associated with infertility and decreased chances of successful IVF treatments.

How is High FSH Treated?

Unfortunately, many fertility clinics still are in the practice of refusing treatment to women with high levels of FSH when, in fact, with proper treatment many women CAN succeed in a pregnancy without the use of an egg donor. Treatments typically focus on identifying the cause of the high FSH and using hormones, such as DHEA, and other methods to help increase the functionality of the ovaries.


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