Diminished Ovarian Reserve

Diminished ovarian reserve is diagnosed when the following issues are present:

• An AMH (anti-mullerian hormone) less than 1
• An antral follicle count less than 10
• A cycle day 3 FSH greater than 9
  

The cause of diminished ovarian reserve is related to age, genetics, environment and lifestyle. Women with diminished ovarian reserve often have low blood flow to the ovaries as confirmed by Doppler ultrasound. Western treatment for diminished ovarian reserve focuses on stimulating the ovaries to produce multiple mature eggs in each cycle. The goal is to find a good quality egg before the ovaries continue aging.

Depending on the AMH or antral follicle count, the method of stimulating the ovaries may include the following:

• Clomid or Letrazole with timed intercourse or IUI
• Low dosed injectable fertility drugs with timed intercourse or IUI
• Minimal stimulation IVF
• Traditional IVF

Diminished ovarian reserve is diagnosed in Chinese medicine as deficiency of the kidney energy of the body (not the actual kidney organ). The kidney energy corresponds to the Western description of genetics and epigenetics. As with genetics, the kidney energy meridian is passed down from the mother and father’s combined kidney energy at the time of conception. Throughout a person’s life, the kidney energy is positively or negatively affected through a person’s environment, dietary choices, stress level, and general lifestyle. This parallels epigenetics description of how gene expression is affected by a person’s lifestyle and environment.

At Revive Acupuncture, we use acupuncture, herbs, dietary recommendations, stress reducing techniques, and exercise recommendations to build and preserve kidney energy. For women under 40 years old, we see amazing results at lowering FSH levels and improving AMH levels through these holistic treatments. For women over 40 years old, our goal is to stabilize the AMH and FSH levels, and because these lab values are supposed to continue to grow out of range with age, stabilization is considered an improvement. 

There is a great deal of research looking at the effect of specific over-the-counter supplements on improving the AMH level as well as IVF success rates. These supplements are made up of amino acids, antioxidants, and low dosed oral hormones. At Revive Acupuncture, we include supplement therapy with most of our low reserve patients, and our recommendations are customized for each patient’s individual lab abnormalities.

Western research investigating acupuncture’s effect on egg quality shows that acupuncture with electric stimulation used on specific points on the body has a strong effect at dilating blood flow to the uterus and ovaries. Increasing blood flow to the ovaries is important for improving egg quality, and improving the response to Western fertility drugs. Increasing blood flow to the uterus is important for supporting a normal uterine lining and prepping for embryo implantation. Additionally, acupuncture has been proven through multiple research studies to improve pregnancy rates when used at implantation times.

At Revive Acupuncture, we re-test ovarian reserve markers every three months if our patients have not yet conceived. By regular monitoring of the ovarian reserve markers, we have confirmation if our fertility treatments are improving, or at least stabilizing ovarian reserve, even if the patient has not yet conceived.