Premature Ovarian Aging
What is Premature Ovarian Aging (POA)?
POA is defined as having a low ovarian reserve or poor ovarian reserve relative to what is expected at any given age. POA is one of the major, often overlooked, causes of female infertility.
Premature Ovarian Aging vs. Early Menopause
Dr. Gleicher discusses the difference between POA and early menopause, and why women with POA still have a good chance of getting pregnant.
The ability of a woman's ovaries to produce high-quality eggs is known as ovarian reserve (OR). As women get older, their OR naturally declines, the number and quality of eggs go down, and it becomes harder to get pregnant. Women attempting pregnancy after age 40 often have difficulty getting pregnant for this reason.
In approximately 10 percent of women, this decline of ovarian function occurs much earlier than is normal. These women are considered to suffer from premature ovarian aging (POA), a clinical term coined by CHR researchers. Women with POA have a hard time conceiving on their own, or even with fertility treatments, if the treatment is not appropriate for their ovarian reserve status. However, with appropriate treatment, women with POA can conceive - as many of our POA patients can testify.
Premature Ovarian Aging and Infertility
POA negatively affects female fertility primarily through sub-optimal number of eggs and poor quality of eggs. Smaller number of lower-quality eggs reduce women’s fertility in two ways: they make it more difficult to get pregnant, and once pregnant, miscarriage are more likely to happen. Unfortunately, quality of eggs declines in parallel to decline in quantity of eggs. Therefore, women with untreated diminished ovarian reservediminished ovarian reserve experience the highest miscarriage rates of any infertility diagnosis because approximately 95 percent of embryo quality comes from the egg, and poor-quality embryos are more likely to result in miscarriages.
POA's Effects on Female Infertility
- Leads to diminished ovarian reserve
- Poor ovarian response to ovarian stimulation in IVF cycles ("poor responder")
- Poor quality eggs
- Poor quality embryos
- Embryos with disproportionately high rate of chromosomal abnormalities (aneuploidy)chromosomal abnormalities (aneuploidy)
- Reduced number of euploid embryos (balanced set of chromosomes)
- Low pregnancy rates
- High miscarriage rates
Last Updated: November 15, 2014