Understanding Diminished Ovarian Reserve: What You Need to Know

Stacia Aaron | Women’s Health Blog | Frisco, TX

Stacia Aaron - MSN, WHNP-BC, IFMCP, IFNCP

Fertility is a deeply personal journey, and for many women, the desire to grow a family can come with unexpected challenges. One of the most significant—yet often overlooked—factors in female fertility is diminished ovarian reserve (DOR). As women’s health practitioners in Frisco, TX, we’re here to guide you through what DOR means, how it affects fertility, and what options are available to support your reproductive health.

What Is Diminished Ovarian Reserve?

Diminished ovarian reserve refers to a decrease in the number and quality of eggs in the ovaries. While it’s normal for ovarian reserve to decline with age, DOR can occur earlier or more rapidly than expected. This condition doesn’t mean a woman is infertile—but it can make conceiving more difficult.

Women are born with all the eggs they will ever have—typically about 1 to 2 million at birth. By puberty, this number drops to around 300,000. With each menstrual cycle, a group of eggs begins to mature, but only one typically ovulates. Over time, the reserve depletes, and the remaining eggs may decline in quality.

Common Causes of Diminished Ovarian Reserve

While aging is the most common cause of DOR, there are several other potential factors:

• Genetics – A family history of early menopause or DOR can increase risk

• Medical treatments – Chemotherapy, radiation, or pelvic surgeries

• Autoimmune conditions – Such as lupus or thyroid disease

• Endometriosis – Particularly if it affects the ovaries

• Environmental toxins – Including cigarette smoke and certain chemicals

• Idiopathic – In some cases, the cause is unknown

DOR can affect women in their 30s, or even late 20s, making early detection critical for those planning to conceive.

Symptoms and Signs

Diminished ovarian reserve may not cause obvious symptoms, especially in its early stages. However, women may notice:

• Shorter or irregular menstrual cycles

• Lighter periods

• Difficulty getting pregnant

• Elevated follicle-stimulating hormone (FSH) levels during testing

• Low anti-Müllerian hormone (AMH) levels

Many women only discover they have DOR when they begin fertility evaluations or experience challenges conceiving.

Diagnosing Diminished Ovarian Reserve

A comprehensive fertility assessment is essential to diagnosing DOR. Key tests include:

• AMH (Anti-Müllerian Hormone) blood test: Indicates the remaining egg supply

• FSH (Follicle-Stimulating Hormone) test: Higher levels may indicate reduced ovarian function

• Antral follicle count (AFC): Ultrasound examination of follicles visible in the ovaries

• Estradiol levels: A form of estrogen that can provide further insight into ovarian activity

These tests help build a clear picture of a woman’s fertility potential and inform appropriate treatment options.

Diminished Ovarian Reserve and Fertility

The primary concern with DOR is its impact on fertility. With fewer and lower-quality eggs, conception may be more difficult—both naturally and with assisted reproductive techniques.

However, DOR is not a definitive barrier to pregnancy. Many women with diminished reserve still conceive, either naturally, with fertility support, or through advanced reproductive technologies.

Treatment Options and Fertility Strategies

The best treatment plan depends on age, individual health history, and fertility goals. Options may include:

1. Lifestyle and Nutritional Support

While lifestyle changes won’t reverse DOR, they can optimize the health of remaining eggs:

• Eat a nutrient-rich, anti-inflammatory diet

• Avoid smoking and limit alcohol

• Maintain a healthy weight

• Manage stress with techniques like yoga or meditation

2. Fertility Medications

Ovulation-stimulating medications, such as Clomid or gonadotropins, may be used to encourage the development of multiple follicles during a cycle.

3. Intrauterine Insemination (IUI)

IUI can be a first-line treatment for women with DOR who are still ovulating but need a little boost to increase the chance of conception.

4. In Vitro Fertilization (IVF)

IVF may offer the best chance of success, especially when combined with egg retrieval and embryo freezing while ovarian function remains. In some cases, donor eggs may be considered.

5. Supplements

Some studies suggest that CoQ10, DHEA, and prenatal vitamins may support egg quality and reproductive health. Speak with your provider before starting any supplement regimen.

Emotional Impact and Support

Facing diminished ovarian reserve can be emotionally overwhelming. Many women experience feelings of grief, confusion, or frustration. That’s why it’s important to work with a compassionate healthcare team who not only understands the medical aspects but also supports your emotional well-being throughout the journey.

Whether you're just starting to think about pregnancy or have been trying without success, knowledge is power. By understanding your ovarian reserve, you can make informed decisions and explore the best paths forward—before options become more limited.

Why Early Testing Matters

If you’re in your early 30s (or younger) and want children in the future, consider fertility testing—especially if you have irregular periods or a family history of early menopause. Early detection allows for more options, including fertility preservation (like egg freezing), which can be life-changing for some women.

At our clinic in Frisco, TX, we offer in-depth fertility assessments to help you understand your reproductive timeline and take control of your fertility future.

Schedule a Discovery Call Today

Diminished ovarian reserve doesn’t have to mean the end of your fertility journey—but the sooner you act, the more choices you have. If you’re struggling to conceive, curious about your ovarian health, or ready to explore your options, we’re here for you.

Schedule a discovery call with our women’s health team in Frisco, TX today. Let’s talk about your goals, review your options, and develop a care plan tailored just for you.

References:

1. American Society for Reproductive Medicine (ASRM). (2022). Testing and interpreting measures of ovarian reserve: A committee opinion. https://www.asrm.org

2. Mayo Clinic. (2023). Diminished ovarian reserve. Retrieved from https://www.mayoclinic.org/diseases-conditions/infertility

3. Practice Committee of the American Society for Reproductive Medicine. (2015). Ovarian reserve testing. Fertility and Sterility, 103(3): e9–e17.

4. Centers for Disease Control and Prevention. (2021). Assisted Reproductive Technology (ART). https://www.cdc.gov/art/index.html