What is Diminished Ovarian Reserve?
DOR occurs when the number and quality of eggs in the ovaries are lower than average for a person’s age. Though this condition can make pregnancy more difficult, it does not eliminate the possibility of conceiving. Early diagnosis and intervention can often improve outcomes for those wishing to start or expand their families.
Symptoms of Diminished Ovarian Reserve
Many individuals with DOR do not experience noticeable symptoms. However, some common signs include:
- Difficulty becoming pregnant after months or years of regular, unprotected intercourse.
- Shorter menstrual cycles than usual.
Causes of Diminished Ovarian Reserve
The causes of DOR can vary and may include:
- Aging: The most common factor, as egg quality and quantity naturally decline with age.
- Genetics: Family history or genetic abnormalities can influence ovarian reserve.
- Medical Treatments: Cancer therapies such as chemotherapy or radiation can significantly impact ovarian function.
- Surgical Interventions: Ovarian surgeries or the removal of one or both ovaries.
- Unknown Causes: In some cases, the cause of diminished ovarian reserve remains unidentified.
Diagnosis of Diminished Ovarian Reserve
Doctors employ various tests to assess ovarian reserve, including:
- Antral Follicle Count (AFC): A vaginal ultrasound to measure the number of follicles in the ovaries.
- Hormone Blood Tests: Measuring levels of follicle-stimulating hormone (FSH) and anti-Müllerian hormone (AMH) can provide insights into ovarian reserve.
- Elevated FSH levels and decreased AMH levels typically indicate reduced ovarian reserve.
These tests assess how well a person may respond to fertility treatments but do not guarantee the ability to conceive naturally.
Treatment Options for Diminished Ovarian Reserve
Though there is no way to reverse the aging or loss of ovarian function, several strategies can help individuals with DOR achieve pregnancy:
- Egg Freezing
Egg freezing is an option for preserving fertility. This process involves using hormones to stimulate the ovaries to produce multiple eggs, which are then retrieved and frozen for future use. In some cases, fertilizing these eggs to create embryos may be recommended.
- Donor Eggs
If egg quality or quantity is significantly compromised, donor eggs may be used. These eggs are fertilized with the sperm of a partner or donor and then implanted into the uterus.
- In Vitro Fertilization (IVF)
IVF remains a popular choice for individuals with DOR. Hormones are used to stimulate the ovaries to produce as many viable eggs as possible. The retrieved eggs are fertilized in a lab, and the resulting embryos are either implanted into the uterus or frozen for later use.
- Embryo Freezing
Embryo freezing involves fertilizing eggs and preserving the resulting embryos for future pregnancies. This can be particularly useful for individuals planning to delay childbearing.
Success Rates of Treatments
The success of fertility treatments depends on several factors, including:
- The underlying cause of diminished ovarian reserve.
- The number of eggs retrieved.
- The body’s response to fertility medications.
It is important to note that, like natural pregnancies, the success rates of IVF decrease with age. Consulting with a fertility specialist can provide personalized recommendations and realistic expectations.
Why Early Diagnosis Matters
Early detection and treatment of diminished ovarian reserve can significantly enhance the likelihood of conception. Routine fertility check-ups and a proactive approach to family planning are essential, particularly for individuals with risk factors such as age or a family history of fertility issues.