Let’s understand how the age of women affects the number and quality of the oocytes. Fertile age of women starts with menarche (beginning of periods) which is about the age of 13 - 14years. Ovarian function ends by the age of 40 years, menopause. So, we can say the reproductive life is about 25-30 years. In the latter half of reproductive life i.e. after the age of 30. Ovarian reserve decreases, the quality and quantity of the oocytes reduces. chances of conception also decrease. If one gets pregnant the possibility of abortion increases.
With reduced ovarian reserve there are more genetic / chromosomal abnormalities in the oocytes. Due to abnormal genes the resultant embryos have genetic abnormality. Almost 90% of these embryos don't implant so there are reduced chances of pregnancy.
Embryos which implant and grow are more likely to have some chromosomal abnormalities, than younger patients. There is more chance of having abnormal babies or babies with birth defects. It is important to do screening tests during pregnancy.
Ovarian reserve can be assessed in many ways. By sonography one can look at the size of the ovary, ovarian volume. Similarly, potential follicles, antral follicle count, can be measured. There are many blood tests like FSH. LH, AMH help us to understand the ovarian reserve.
Time is the key. There are many medications to improve ovarian reserve. These are also called ovarian tonics. Medicines have very little effect. There is no magic pill which will reverse the ovarian reserve. So, it is important to plan the pregnancy at an earlier age. If oocyte quality is poor or there are no responses to ovarian stimulation. Option of egg donation needs to be considered.