So much for great egg-spectations.
Most women are born with an ovary on each side of their uterus. These almond-shaped glands produce and release eggs for fertilization and secrete the hormones estrogen and progesterone to support menstruation, pregnancy and overall health.
Alas, these vital female organs have an expiration date — and it’s earlier than you might think. Ovaries age significantly faster than other parts of the body, making their functional lifespan about 50 years.
“Ovaries follow a biologically programmed decline in both egg quantity and quality, not a uniform aging process like skin, muscle or cardiovascular tissue,” Dr. Roxanne Pero, Inito‘s medical adviser and a triple-board-certified OB/GYN, told The Post.
“As a result, reproductive aging often occurs faster and earlier than most other aspects of physical aging.”
While the number of eggs that women are born with is genetically predetermined, there are potential ways to optimize ovarian longevity and become an ova-achiever.
How does ovarian aging work?
Women tend to be born with 1 million to 2 million eggs, a number that naturally decreases over time. The more good-quality eggs a woman has, the better her chances of pregnancy.
But obstacles abound. Women experience a progressive decline in their egg quality and in their ovarian follicles, which house immature eggs. Fertility wanes, increasing the risk of miscarriage or genetic abnormalities in offspring, and, eventually, menopause tends to set in around age 51.
“Subtle declines in egg quality begin in the late 20s to early 30s, even when cycles still appear normal,” Pero explained.
“Egg quantity (ovarian reserve) tends to show more measurable decline starting around the early 30s, with a steeper drop after age 35,” she continued. “By the late 30s and early 40s, both egg quality and quantity typically decline more rapidly, even before menopause.”
Ovarian aging and the resulting drop in reproductive hormones “contribute to other signs of aging, such as bone health and density and skin integrity,” Dr. James Stelling, medical director of Stony Brook Medicine’s Island Fertility in Commack, told The Post.
That’s why it’s important to take charge of ovarian aging — it drives physical and cellular aging throughout the body.
How is ovarian age measured?
There’s not a specific test that reveals ovarian age. Physicians often look at levels of follicle-stimulating hormone (FSH) and estradiol (the primary form of estrogen) for insight into ovarian reserve, which is the remaining egg supply.
“A transvaginal sonogram can also count the number of little eggs seen in each ovary, often called a basal antral follicle count,” Stelling said.
“The best measure of ovarian reserve is the hormone AMH, or anti-Müllerian hormone, which can be measured at any time of the cycle.”
Cells within growing ovarian follicles produce AMH, a protein that indicates egg quantity but not quality.
Can ovarian function be preserved?
“The best way to preserve ovarian function as it relates to fertility is to freeze eggs,” Dr. Adi Davidov, associate chair of the Department of Obstetrics and Gynecology at Northwell’s Staten Island University Hospital, told The Post.
Aim to freeze eggs in your 20s or early 30s, when they tend to be higher in quality and quantity.
Eating healthily, sleeping well, exercising, managing stress, avoiding smoking and limiting exposure to toxins can also support hormonal and reproductive health.
Can ovarian aging be slowed or reversed?
“It would be wonderful if we had a magic wand to make ovaries or any part of the body younger, but we are not really there yet,” Stelling said.
Targeting ovarian stiffness is one area that’s being explored. As ovaries age, the surrounding tissue becomes rigid, inflamed and scarred. The scarring is known as fibrosis.
Enter pirfenidone, an FDA-approved drug for lung scarring that has shown early promise for reducing ovarian stiffness and scarring.
“Most research so far is in mouse models and has been looked at in humans [with] the condition PCOS now called PMOS,” Stelling cautioned.
“It’s still too early to really know its effect in human fertility preservation or treatments, but worthy of study.”
Polyendocrine metabolic ovarian syndrome (PMOS), which affects roughly 1 in 8 women, is characterized by hormonal imbalances that disrupt ovarian function. It’s a leading cause of female infertility.
Pero said women concerned about their fertility tend to ask her about longevity measures such as rapamycin, red light therapy, platelet-rich plasma ovarian injections, NAD infusions and hyperbaric oxygen.
She said some of these tools may help reduce oxidative stress in ovarian tissue, support mitochondrial function in remaining follicles and slow the rate of decline.
“But ovarian aging is fundamentally driven by the loss of a follicle pool you were born with and cannot regenerate,” Pero noted.
“The goal isn’t reversal — it’s preservation, optimization and buying your body more time with the hormonal output it still has.”
