Q. My reproductive endocrinologist told me that I have diminished ovarian reserve. What does this mean, and how does he know that this is the case?
Diminished ovarian reserve (DOR) means that you have significantly fewer eggs in your ovaries than your doctor expects given your age. If you want to dig further, you can read more in-depth information about DOR in our Infertility 101 section.
Most reproductive endocrinologists (RE) use a few different tests to determine whether a woman has DOR.
Basal antral follicle count. First, it's important for the RE to visualize the ovaries. Utilizing transvaginal ultrasound imaging during the first few days of a woman's menstrual cycle, the RE counts the number of small, resting follicles. A normal antral follicle count yields at least 8 or 9 follicles; fewer than that and the woman is suspected of having DOR.
Serum FSH test. A simple blood draw at the beginning of the menstrual cycle allows the RE to test for diminished ovarian reserve by measuring serum FSH (follicle stimulating hormone). Assuming that other labs (such as estradiol) are normal, then an elevated FSH (greater than 18 miu/mL) indicates a serious reduction in ovarian reserve.
It is important to understand that diminished ovarian reserve makes infertility treatment much more complicated. Mainstream treatments such as IVF (in vitro fertilization) and IUI (intrauterine insemination) depend on the ability to stimulate the growth several follicles; DOR means that a woman has significantly fewer follicles to try and stimulate. If you've been diagnosed with DOR, be sure to talk to your doctor immediately about your treatment options. An immediate, aggressive treatment plan is often the best choice in this situation, and time is fertility.
What is Diminished Ovarian Reserve?