What Is Diminished Ovarian Reserve?
Diminished ovarian reserve (DOR) is a condition that primarily impacts women and manifests as a reduction in both the quantity and quality of eggs (ova) stored within the ovaries. This medical condition is a prevalent factor contributing to infertility, significantly influencing a woman's reproductive health and her capacity to conceive through natural means.
In a woman's reproductive years, the ovaries contain a finite number of eggs. These eggs gradually decrease in number and quality as a woman ages. However, in some cases, the decline in egg quantity and quality occurs at a faster rate, resulting in diminished ovarian reserve.
Factors causing diminished ovarian reserve
Several factors can contribute to diminished ovarian reserve. Age is the most significant factor, as the decline in ovarian function accelerates after the age of 35. Genetic factors can also play a role, as some women may have a predisposition to premature ovarian ageing. Certain medical conditions, such as endometriosis or previous ovarian surgery, may also affect ovarian reserve. Additionally, certain cancer treatments, such as chemotherapy or radiation, can have a detrimental impact on ovarian function.
Symptoms/indications of diminished ovarian reserve
One of the key indicators of diminished ovarian reserve is a decreased anti-Müllerian hormone (AMH) level. AMH is produced by the ovarian follicles, and its level in the blood provides an estimate of the remaining egg supply. A low AMH level suggests a reduced ovarian reserve. Another important marker is an elevated follicle-stimulating hormone (FSH) level, which indicates that the brain is producing more FSH to stimulate the ovaries, potentially due to decreased ovarian response.
Women with diminished ovarian reserve may experience difficulties in conceiving naturally. They may have irregular menstrual cycles or longer intervals between periods. The quantity and quality of their eggs may be insufficient for successful fertilisation and implantation. As a result, they may require assisted reproductive technologies, such as in vitro fertilisation (IVF), to achieve pregnancy.
Treatment
Treatment options for women with diminished ovarian reserve are limited. And the success rates can vary. In some cases, fertility medications can be prescribed to stimulate the ovaries and increase the number of mature eggs produced during a cycle. However, the response to these medications may be suboptimal. IVF may be recommended to overcome the challenges associated with diminished ovarian reserve.
In IVF, multiple eggs are retrieved from the ovaries, fertilised in the laboratory, and the resulting embryos are transferred into the uterus. This procedure maximises the chances of achieving a successful pregnancy, although the individual success rates depend on various factors, including the woman's age and overall health.
For women who are unable to conceive using their own eggs, alternative options such as egg donation or adoption may be considered. These options provide the opportunity to build a family despite diminished ovarian reserve.
Conclusion
Diminished ovarian reserve is a condition characterised by reduced egg quantity and quality in the ovaries, leading to difficulties in conceiving naturally. Age, genetics, medical conditions, and cancer treatments can contribute to this condition. Women with diminished ovarian reserve may require fertility treatments such as IVF to achieve pregnancy, and the success rates can vary. While the condition can present challenges, there are still options available to help women build a family and fulfil their desire to become parents.
