The term “ovarian reserve” refers to the number of eggs and the quality of eggs inside a woman’s ovaries that presents her fertility. Diminished Ovarian Reserve (DOR) is the condition where there is a loss of normal reproductive potential in the ovaries. Earlier it was assumed that the condition occurs due to lower count or quality of remaining eggs in the ovaries. But after a 2015 paper pointed out that DOR is diagnosed by blood tests measuring the hormonal levels and not by counting the eggs, the clear definition of this condition is unclear. Aging was also accounted for having diminished ovarian reserve since the number of eggs (6-7 million) in a woman’s body while she is still an embryo keeps on decreasing as she ages and reaches menopause (1,000 eggs). Some of the factors that cause diminished ovarian reserve are :

• tubal disease
• endometriosis
• prior ovarian surgery
• chemotherapy
• radiation therapy
• smoking
• pelvic infection
• autoimmune disorders
• mumps
• genetic abnormalities such as fragile X syndrome

There are no severe noticeable symptoms at early stages that might emphasize a woman having diminished ovarian reserve. However woman having DOR may experience difficult getting pregnant, late/absent menstrual periods, shorter menstrual cycle, heavy menstrual flow, miscarriage. If you are attempting to conceive without progress or have a history of irregular or painful cycles, pelvic inflammatory disorder, multiple miscarriages, previous cancer treatment, or endometriosis, it is crucial to get fertility tests early. Early diagnosis suggests that you have a higher chance of treatment being successful. But for the most part women find out they have DOR, after diagnostic tests. These include transvaginal ultrasound, follicle stimulating hormone (FSH), estradiol (a type of oestrogen), and anti-Müllerian hormone (AMH) hormone assessments.

Treatments

Pregnancy with a diminished ovarian reserve is still possible. Supplements such as dehydroepiandrosterone (DHEA), a moderate androgen, are one of the most effective therapies for reduced ovarian reserve. In the body, DHEA is created naturally, but with age, levels of DHEA decrease. Supplements with DHEA will improve fertility.