Women in their 20s fear pregnancy, while women in their 30s fear their ovaries “going on strike.” Modern women who pursue self-fulfillment often forget that their “limited number of eggs” is also “time-limited.” They unknowingly wear down their ovarian age. What’s more frightening is that at the age of 30, their ovaries may have already quietly “aged” to 45. Only when they want to get married or have children do they discover they are facing Premature Ovarian Failure (POF)—and regret it deeply.
Is it premature ovarian failure? 5 key indicators to assess ovarian age
Under normal conditions, a woman experiences approximately 400 ovulatory cycles in her lifetime. Ovarian function typically declines after age 45, leading to what is commonly known as menopause. However, with modern women marrying and having children later in life, they are gradually approaching their “ovarian deadline.”
In one clinical case, a 32-year-old woman worked tirelessly to rise to a senior role at a PR and marketing firm. After finally agreeing to marry her long-time boyfriend, her menstrual periods became irregular during their honeymoon period. When her period was delayed for nearly four months, she thought she was pregnant. But a gynecological exam brought devastating news: she had premature ovarian failure and had already entered menopause early.
Dr. Ming-I Hsu, Director of Huayu IVF Clinic and a long-time specialist in infertility treatment, explains: if a man’s testicles are like a factory that continuously produces sperm, then a woman’s ovaries are more like a warehouse—her egg supply is fixed from birth. “By the age of 30, a woman has used up about 80% of her eggs.” Since egg reserves are irreversible, women must pay close attention to their “ovarian age.”
※ Self-check indicators for declining ovarian function:
-Irregular menstrual cycles
-Shorter period duration
-Lighter menstrual flow
-Insomnia
-Hot flashes, night sweats, mood swings
When a woman’s body begins to show signs of ovarian aging, it may be signaling the arrival of menopause—potentially a devastating blow to those trying to conceive. After all, the formation of an embryo requires substantial energy, and the quality of eggs is key to supporting the many cell divisions after fertilization. Dr. Hsu, who has handled numerous clinical cases, emphasizes that even though ovulation may still occur at age 45, the aging of egg quality significantly reduces natural pregnancy rates. “The chances of conceiving naturally in the 10 years before menopause are already extremely low.”
Essential for modern women! AMH testing identifies early ovarian failure
Since a woman’s “fertility potential” depends on age and ovarian condition, reproductive medicine in recent years has focused heavily on these factors. Ovarian age can be evaluated by monitoring hormone levels in the body. Traditionally, Follicle Stimulating Hormone (FSH) has been used as an indicator, but by the time FSH levels signal a lack of ovulation, it may already be too late. Modern medicine now prefers Anti-Müllerian Hormone (AMH) as a more accurate measure, since it reflects the number of follicles remaining in the ovaries.
Follicle Stimulating Hormone (FSH):
Each month, several follicles in the ovary begin to mature. As they develop and prepare to ovulate, the body secretes FSH. During the follicular phase, FSH levels typically range from 3.5 to 12.5 mIU/ml, and during ovulation rise to 4.7–21.5 mIU/ml. In menopausal women, FSH levels spike to 25.8–134.8 mIU/ml.
If a woman’s FSH level stays at or above the threshold of 25 mIU/ml for an extended period, it may indicate that ovarian function is already in decline.
Anti-Müllerian Hormone (AMH):
Immature follicles in the ovaries produce AMH, which indicates the ovarian reserve. A normal AMH level ranges from 2 to 5 ng/ml. A level below 2 ng/ml is a warning sign of early ovarian failure. “The closer it is to 0, the closer it is to complete ovarian failure.”
Doctors generally recommend that adult women have their AMH levels tested every 2 to 3 years to monitor ovarian health.
“As women, our lives are influenced by menarche, menstruation, and menopause. Ovarian age directly affects lifelong happiness,” says Dr. Hsu. He recommends women over 25 undergo regular blood tests to check their AMH index.
Ovaries have a built-in ‘expiration date’—a healthy lifestyle can slow aging of the eggs
Every woman wants her ovaries to age slowly. This awareness is unique to women. OB/GYN doctors commonly advise avoiding the six major causes of premature ovarian failure:
※Main causes of premature ovarian failure:
1.Environmental toxins or cancer treatments (radiation/chemotherapy)
2.Autoimmune diseases
3.Viral or bacterial infections causing inflammation
4.Chronic stress
5.Ovarian-related diseases
6.Poor habits like staying up late, smoking, and drinking
Clinicians recommend women avoid fried and grilled foods, maintain a regular exercise routine, and manage stress appropriately to support ovarian health. Dr. Hsu believes that while a healthy lifestyle can somewhat reduce oxidative stress on the ovaries, “the natural limit of ovarian function is the key factor.” For modern women, awareness of ovarian age is an essential part of self-care.
Dr. Ming-I Hsu
Disciple of the father of IVF in the U.S., the only direct student in Taiwan
Current Roles
Director, Huayu IVF Clinic
Certified Professor, Ministry of Education
Vice President, 2nd Board, Reproductive Medicine Committee, World Federation of Chinese Medicine Societies
Past Experience
Professor, Department of Obstetrics and Gynecology, Taipei Medical University
Director, OB/GYN Department, Wan Fang Medical Center, TMU
Head, Reproductive Medicine Laboratory, Wan Fang Medical Center
Director, Teaching Department, Wan Fang Medical Center
Director, Faculty Development Center, Wan Fang Medical Center
