Ovarian reserve measures fertility potential based on the quantity and quality of remaining eggs. Diminished ovarian reserve (DOR) leads to reduced fertility. At Everleap Fertility, we specialize in treating DOR to help individuals in their fertility journeys.
Diminished ovarian reserve is a decline in the reproductive potential of a person’s ovaries, often due to age. People with ovaries are born with a fixed amount of eggs, and this number naturally declines following the peak reproductive years -which are between the late teens and early 20s.
Some medical conditions and genetic disorders can cause some people to experience DOR or early menopause at a younger-than-expected age.
Age is one of the most common causes of diminished ovarian reserve (DOR). Egg quantity and quality typically decline with age, with the decline accelerating after age 40, which can make it more difficult to conceive. DOR can also be associated with other factors, including chemotherapy or radiation therapy, smoking or tobacco use, ovarian surgery or the loss of an ovary, certain genetic conditions, autoimmune diseases, galactosemia, and mumps.
IVF is often the first line of treatment since time is of the essence, though some patients prefer to start with IUI – a choice we support. Another avenue some families explore is the use of donor eggs.
IVF may be recommended for people with diminished ovarian reserve because it allows your care team to stimulate the ovaries, retrieve available eggs, and fertilize them in the lab. Your treatment plan and medication protocol can be tailored to your ovarian reserve and how your ovaries are expected to respond.
For some people with diminished ovarian reserve, IUI may be an option depending on age, ovarian function, sperm health, and other fertility factors. During IUI, prepared sperm is placed directly into the uterus around the time of ovulation to help sperm reach the egg.
Donor eggs may be an option when using your own eggs is unlikely to result in pregnancy or when previous fertility treatments have not been successful. Donor eggs are fertilized with partner or donor sperm through IVF, and the resulting embryo is transferred to the uterus. Egg donors complete a comprehensive screening process before donation.
After 3 years of trying on my own without success I knew something wasn't right. I decided to seek infertility help. After some lab work and tests, I was found to have diminished ovarian reserve (DOR).”
Angela
When you’re navigating diminished ovarian reserve, having the right team matters. We take a holistic, personalized approach that considers your hormonal, metabolic, and reproductive health. As part of a collaborative network of fertility specialists, you’ll receive individualized care backed by decades of expertise.
We’ve cared for individuals going through diminished ovarian reserve, developing the clinical expertise to provide accurate diagnoses, thoughtful treatment recommendations, and compassionate care.
Our physicians stay at the forefront of reproductive medicine through ongoing research, collaboration, and continuous education, bringing the latest evidence and treatment advances directly to our patients.
Fertility is connected to your overall health. Our holistic approach considers factors such as nutrition, metabolic health, lifestyle, and emotional well-being alongside your fertility care, helping create a plan that supports you as a whole person.
Often, there are no noticeable symptoms of diminished ovarian reserve. Some people may experience shorter menstrual cycles, hot flashes, or vaginal dryness, but testing is the best way to better understand your ovarian reserve.
Your fertility specialist may use bloodwork and an ultrasound to assess your ovarian reserve. Blood tests can measure hormones including AMH, FSH, and estradiol, while an ultrasound can measure your antral follicle count (AFC)—the number of visible follicles in the ovaries. Together, these results help your doctor understand your egg supply and how you may respond to fertility medications.
A DOR diagnosis does not mean pregnancy is impossible. Some people with a smaller number of eggs are able to conceive without treatment, while others may benefit from fertility care. Your age, egg quality, ovarian reserve, and other fertility factors can all help your specialist determine a targeted path forward.