Diminished Ovarian Reserve
Diminished Ovarian Reserve (DOR) has been defined several ways. Some women receive the diagnosis based on an elevated follicle stimulating hormone (FSH) level usually above 9.0 miu/ml or possibly a decreased level of anti Mullerian hormone or inhibin B. A low antral follicle count (AFC) could also be used to define this condition. Women over age 38 are more commonly found to have diminished ovarian reserve as well.
Diminished ovarian reserve may be better defined by evaluating a woman’s response to gonadotropins (FSH or FSH/LH) hormones. Typical responses that would be considered low or diminished would be a mature follicle count at the end of stimulation of 5 or less and/or an estradiol level less than 500 pg/ml.
Patients with diminished ovarian reserve will typically need more treatment cycles to achieve a healthy pregnancy than women with normal ovarian reserves. Patients with diminished ovarian reserve may require a provider that can “think outside the box” more so than a limited traditional provider.
There are so many factors that go into the decision of how to best treat patients with diminished ovarian reserve. It is important that patients receive care that reflects all of their critical information and that their treatment is individualized to maximize their chance for a successful pregnancy.