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Diminished Ovarian Reserve (DOR) is a condition where a woman's ovaries have a reduced quantity or quality of eggs, leading to a decline in fertility and potential difficulties in conceiving. In this article, we will delve into the causes, symptoms, diagnosis, and treatment options for Diminished Ovarian Reserve.

What is a Diminished Ovarian Reserve?

Diminished Ovarian Reserve refers to the reduced quantity and quality of eggs in a woman's ovaries, affecting her ability to conceive and bear children. This condition is a significant concern for women attempting to get pregnant, particularly those over the age of 35.

Who can get a Diminished Ovarian Reserve?

Diminished Ovarian Reserve is primarily observed in women who are approaching or are in their late 30s and 40s, as ovarian function naturally declines with age. However, it can also occur in younger women due to various medical conditions or treatments.

What are the Types of Diminished Ovarian Reserve?

Diminished Ovarian Reserve can be categorized into three types:

1. Primary DOR: Occurs due to natural ageing and is associated with reduced egg quantity and quality.

2. Secondary DOR: Results from medical interventions such as surgery, chemotherapy, or radiation that impact ovarian function.

3. Occult DOR: Presents with normal menstrual cycles but diminished ovarian function, often diagnosed during fertility testing.

What are the Causes of Diminished Ovarian Reserve?

Several factors can contribute to Diminished Ovarian Reserve:

  • Age: Aging is a primary cause, as the number and quality of eggs decline with advancing age.
  • Genetic Factors: Some individuals may have a genetic predisposition to early ovarian ageing.
  • Medical Treatments: Chemotherapy, radiation, or ovarian surgery can damage the ovaries and reduce their functioning.
  • Autoimmune Disorders: Certain autoimmune conditions can adversely affect ovarian function.
  • Smoking and Substance Abuse: These can accelerate the decline in ovarian reserve.

  • Environmental Factors: Exposure to certain environmental toxins may contribute to DOR.

What are the Symptoms of Diminished Ovarian Reserve?

Diminished Ovarian Reserve may not manifest noticeable symptoms early on. However, as the condition progresses, some signs may become evident:

  • Irregular menstrual cycles
  • Difficulty in getting pregnant

  • Reduced or absent premenstrual symptoms

  • Lowered response to fertility treatments like in vitro fertilization (IVF)

Does Diminished Ovarian Reserve Affect Fertility?

Diminished Ovarian Reserve significantly affects fertility. The diminished quantity and quality of eggs reduce the likelihood of successful fertilization and implantation, making it harder to conceive. Additionally, it can increase the risk of miscarriages and chromosomal abnormalities in embryos.

How is Diminished Ovarian Reserve Diagnosed?

Diagnosing Diminished Ovarian Reserve involves several tests and evaluations:

  • Hormone Testing: Blood tests for follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, and anti-Müllerian hormone (AMH) levels.

  • Antral Follicle Count: An ultrasound to count the number of small follicles in the ovaries, indicating ovarian reserve.

  • Ovarian Reserve Assessment: Evaluating menstrual cycle regularity and levels of inhibin B, a hormone produced by developing ovarian follicles.

How is Diminished Ovarian Reserve Treated?

While Diminished Ovarian Reserve is challenging to treat, various approaches can help improve fertility or assist in conception:

  • In Vitro Fertilization (IVF): Stimulating the ovaries with fertility drugs to retrieve multiple eggs for fertilization and implantation.

  • Egg Donation: Using eggs from a healthy, young donor in an IVF cycle to increase the chance of successful conception.

  • Pre-implantation Genetic Testing: Screen embryos for chromosomal abnormalities before implantation to improve the chances of a healthy pregnancy.

  • Ovarian Rejuvenation Techniques: Experimental procedures aiming to enhance ovarian function, although their efficacy and safety are still being researched.


Diminished Ovarian Reserve can be a distressing challenge for women desiring to have children. Understanding the causes, symptoms, diagnosis, and available treatments is crucial in managing this condition and exploring viable options for conception. Seeking guidance from fertility specialists and considering various treatment alternatives can offer hope and support in the journey to parenthood.

Frequently Asked Questions (FAQs)

Can Diminished Ovarian Reserve be prevented?


Diminished Ovarian Reserve, especially related to age, is a natural process and cannot be prevented. However, a healthy lifestyle, avoiding smoking and excessive alcohol consumption, and managing underlying health conditions may help maintain ovarian health.

Is natural conception possible with a Diminished Ovarian Reserve?


While natural conception becomes more challenging with a Diminished Ovarian Reserve, it is still possible, especially in the early stages of the condition. Consulting a fertility specialist for personalized advice and treatment options is recommended.

Are there any alternative or complementary therapies for treating Diminished Ovarian Reserve?


Certain complementary approaches like acupuncture, dietary changes, and stress reduction techniques may be explored to support fertility, although their effectiveness varies from person to person. It's essential to discuss these options with a healthcare professional.

Can hormone therapy improve ovarian function in cases of Diminished Ovarian Reserve?


Hormone therapy may be considered to stimulate the ovaries and improve egg production in individuals with Diminished Ovarian Reserve. However, the efficacy and appropriateness of this approach depend on individual circumstances and should be discussed with a fertility specialist.

What is the success rate of IVF in individuals with a Diminished Ovarian Reserve?


The success of IVF in individuals with Diminished Ovarian Reserve varies based on several factors, including age, overall health, and the specific case. Success rates may be lower compared to younger individuals with a healthy ovarian reserve, but consulting a fertility specialist can provide a more accurate assessment based on the individual's situation.


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