To understand what Premature Ovarian Aging is, we need to first take a better look at the primary players – your ovaries. Inside each healthy woman there are 2 ovaries, one on either side of your uterus. Perched below the delicate fringed fingers of your fallopian tubes, these magnificent mini spheres act as the reserve for all of your potential eggs.
Each woman is born with all the eggs that she will ever have, hundreds of thousands of them, and they are individually wrapped in follicles – like a hollow ball of cells with the immature eggs in the center. At the beginning of each monthly cycle, the pituitary gland inside your brain, acting as an agent for your hypothalamus (the hormonal command center), releases hormones into your bloodstream that travel to your ovaries and tell them to start maturing eggs. In other words, your brain keeps in constant contact with the rest of your body to keep things moving on a rough schedule.
When your ovaries get word that it’s time to select another contestant to come on down to the uterus for a chance at fertilization, they take turns auditioning a set of several individual follicles for cultivation. According to Dr. Vitaly Kushnir, Director of Fertility Preservation at the Center for Human Reproduction, “For young women, that is usually more than 10, sometimes more than 20 eggs each month.” This batch of potential stars all begin development until one breaks free from the follicle, erupts from the ovary and gets swept away by the adoring folds of the fallopian tube. The others, spent from the race, fade away as it were. Every other month each ovary gets a turn to select a new batch of hopefuls and release a single egg. The outcomes from this exercise are usually either menstruation (egg remains unfertilized) or pregnancy (egg gets fertilized).
While most of us focus on the fate of the single egg at center stage, we overlook all the follicles that are auditioned in our quest to release only the best and the brightest. These follicles that don’t get selected are no longer available for later use and so each month, you are actually using and losing multiple follicles during each cycle. For most women, there is little worry that they will run out of quality contenders before their forties, when menopause slows the process to an eventual halt. But for 10% of us, quality and quantity will fade faster. The natural effects of age lower the vivacity and capacity of your follicle stock but additional factors like autoimmune function, irregular genetic programing and possibly other factors that doctors haven’t identified yet can speed this decline. When this occurs you end up having fewer leading ladies to choose from as time goes by, and fewer chances to conceive even with medical support.
If you are diagnosed with Premature Ovarian Aging, your ovaries have fewer and lower quality eggs than other women your age. This elevated rate of loss leaves you with fewer choices during the ovulation selection and fewer cycles. And with lower quality eggs getting chosen to headline out of necessity, you may have a smaller chance of pregnancy, and even when a pregnancy is established, you may have increased chances of miscarriages.