Poor Ovarian Reserve - Etiology

Etiology

• Natural decline of ovarian reserve due to age.
• Idiopathic.
• Genetic factors, such as fragile x syndrome. Approximately 20–28% of women with an FMR1 premutation (55–200 CGG repeats) experience fragile x primary ovarian insufficiency (POI) and another 23% experience early menopause (i.e., menopause before the age of forty five).
• Autoimmune disorders.
• Adrenal gland impairment.
• Iatrogenic, e.g., due to radiation, chemotherapy or surgery, such as laserization of the surface of the ovary to treat endometriosis. Excessive laparoscopic ovarian drilling has been reported to cause premature ovarian failure. (The primordial follicles are located in the thin outer one-millimeter layer of the ovary.)