Bengaluru doctors see rising cases of low ovarian reserve in women in their 20s & 30s
Bengaluru: Fertility specialists across Bengaluru are raising a red flag:
Low ovarian reserve
, a condition traditionally seen in women nearing their 40s, is now increasingly being diagnosed in much younger women.
More women in their 20s and early 30s, who are planning their pregnancies, are walking into fertility clinics only to discover their egg count is significantly lower than expected for their age. Low ovarian reserve usually doesn't present with any or unnoticeable symptoms. Doctors warn this shift could have serious implications for fertility planning and reproductive health.
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Dr Manjunath, deputy medical director at Birla Fertility and IVF, told TOI he sees at least 40 cases a month. "Every alternate patient, in the age group of 20 to 30 years we see now, has a low egg reserve. The number rose exponentially in the last two decades."
He explained a woman is born with all the eggs she'll ever have — about 1 to 2 million. By puberty, it drops to 3–4 lakh. And by 30? Just around 70,000. From there, the decline picks up speed. "Now, more young women are now facing egg depletion faster than expected, even when they're years away from planning a pregnancy. While age remains the most significant factor, it is a mix of urban lifestyle choices, environmental exposure, and delayed family planning. The biological clock is set. We can't reset or slow it," he said.
Dr Priyanka Das, consultant obstetrician, gynae laparoscopic surgeon & infertility specialist, Altius Hospital, sees about 10 to 15 such cases every month. "Stress, pollution, processed diets, and hormonal disruptors in plastics and cosmetics may all be contributing," she said.
The Anti-Müllerian Hormone (AMH) level is a key marker for egg reserve. A healthy range is between 2 and 4 ng/mL. Anything below 1 is considered critically low. The Antral Follicle Count (AFC)—the number of egg follicles seen on an ultrasound—is also used. A normal AFC ranges between 6–10 follicles per ovary. "When AMH drops below 1, and AFC shows 2 to 5 follicles, we call that severely diminished reserve," said Dr Meghana Nyapathi, cluster head at Milann Fertility Hospital. "We see 30 patients a month who now present with this."
This isn't just about getting pregnant. The quality of eggs also declines, increasing the risk of miscarriage and chromosomal issues. Dr Manisha Singh, additional director - gynaecologist & subspecialist in reproductive medicine & surgery at Fortis Hospital, explained, "Only one egg ovulates each month. The rest die unused. And with age or damage from things like smoking or surgeries, the remaining ones may be poor in quality." She added there is an increase in the rise of conditions like endometriosis that lead to cyst formation in the ovary, which can also compromise the egg reserve.
Dr Meghana Nyapathi, cluster head - reproductive medicine at Milann Fertility Hospital, said, "Approximately 30% of patients each month present with low ovarian reserve, leading to difficulties in conceiving. Sadly, a poor ovarian reserve is generally not reversible."
Precautions:
Quit smoking
Limit alcohol intake
Follow a balanced diet
Maintain healthy body weight
Manage stress
Plan pregnancy before 35
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