Will IVF cause me to run out of eggs ?

I just got this email from one of my patients." How many unsuccessful IVF attempts does a person like me go through before AMH levels get impacted and early menopause sets in?

This is a very common concern many IVF patients have. They feel that pumping their body full of hormones in each IVF cycle is bound to have a deleterious effect on their body - no matter what the medical studies show. This is a very real fear , which is often not articulated.

" IVF will never cause you to have an early menopause. Let's look at some basic reproductive biology to understand why this is true. Every month , about 40 ovarian follicles start growing. This is called follicular recruitment, and occurs as a result of the production of FSH ( follicle stimulating hormone) . Of these, only one matures . This is why most women normally have just one baby at one time ( unlike rabbits, who have a litter, because many of their eggs mature simultaneously every month). What happens to the others ? They naturally undergo a process of atresia every month. What this means is that about 39 follicles "die" every month, whether or not you do ICSI. In each IVF cycle, we are only rescuing the follicles which would have died anyway, so you will not run out of eggs any sooner as a result of doing IVF ! This is why the risk of ovarian cancer is also not increased as a result of using these drugs. All these superovulation drugs are natural hormones - we are just mimicking the natural process, but improving its efficiency by growing many eggs at one time ! Now it is true that some infertile women have poor ovarian reserve. These women will have an early menopause because of their impaired ovarian reserve. Now, many of them will blame their IVF cycles for this - but the fact is that they would have had an early menopause, whether or not they had done IVF ! "