So You Were Diagnosed With Diminished Ovarian Reserve: What Now?

Diminished Ovarian Reserve (DOR) is a condition that affects many women, often catching them off guard as they embark on their journey to parenthood. While receiving a DOR diagnosis can be challenging, understanding the condition is the first step in navigating your reproductive options. This article aims to demystify DOR, explore its prevalence, discuss the chances of conception, and outline the available options for those diagnosed with this condition.

What is diminished ovarian reserve (DOR?)

Diminished ovarian reserve refers to a reduction in the quantity of your remaining eggs. Every female is born with all the eggs she'll ever have, and this number naturally declines with age. However, some experience a faster decline than expected for their age, leading to a diagnosis of DOR.

DOR is not the same as infertility. While it can make conception more challenging, it doesn't necessarily mean pregnancy is impossible. Instead, think of DOR as a warning sign that your reproductive window may be shorter than anticipated. The sooner you get a DOR diagnosis. The sooner you can begin to explore your reproductive options, including treatments like in vitro fertilization (IVF) or egg freezing, and potentially increase your chances of achieving a successful pregnancy.

How common is diminished ovarian reserve?

The prevalence of DOR increases with age, but it can affect women of all ages. According to one study, approximately 10% of women seeking fertility treatment are diagnosed with DOR. However, this number may not accurately represent the general population, as many women with DOR may not seek fertility treatment or may remain undiagnosed.

Age is the most significant risk factor for DOR. As women approach their late 30s and early 40s, the likelihood of experiencing DOR increases significantly. However, DOR can also occur in younger women too, sometimes due to genetic factors, medical treatments like chemotherapy, or unknown causes.

Some lifestyle factors have also been known to contribute to a diminished ovarian reserve. Smoking is one of the most significant factors, as a history of heavy smoking can accelerate the loss of eggs and may lead to earlier menopause. 

Diagnosing diminished ovarian reserve

Diagnosis of DOR typically involves a combination of blood tests and ultrasound imaging. The most common blood tests measure levels of follicle-stimulating hormone (FSH) and anti-Müllerian hormone (AMH). High FSH levels or low AMH levels can indicate DOR. Additionally, an ultrasound to count antral follicles (small follicles in the ovaries) can provide further insight into ovarian reserve.

It's worth noting that these tests provide a snapshot of your current ovarian reserve, not a prediction of your ability to conceive. A low ovarian reserve doesn't necessarily mean you can't get pregnant, just as a high reserve doesn't guarantee conception.

Chances of getting pregnant with diminished ovarian reserve

The probability of achieving pregnancy without assistance (meaning “the old fashioned way”) when diagnosed with DOR varies widely depending on individual factors, including age, the severity of the condition, and overall health. A study published in JAMA found that women aged 30-44 with low AMH (an indicator of DOR) did not have a significantly different probability of conceiving after six months of trying.

However, these statistics don't tell the whole story. Some women with DOR do conceive unassisted, while others may require IVF or donor egg IVF. Every woman's fertility journey is unique, and statistics can't predict individual outcomes.

Options for women diagnosed with DOR

If you are facing infertility due to DOR or other reasons, the good news is that there are options. Here are some paths you might consider:

1. Fertility treatments

For women with DOR who wish to conceive using their own eggs, fertility treatments can potentially improve the chances of pregnancy. These may include:

• Ovulation Induction: Medications to stimulate egg production
• Intrauterine Insemination (IUI): A procedure where sperm is placed directly into the uterus
• In Vitro Fertilization (IVF): A process where eggs are fertilized outside the body and then transferred to the uterus

It's worth noting that success rates for these treatments may be lower in women with DOR compared to those with normal ovarian reserve. A fertility doctor can give you a better idea of your chances of success based on your unique health history. 

2. Egg donation

For some women with DOR, using donor eggs may offer the best chance of achieving pregnancy. This option allows for the experience of pregnancy and childbirth, even if the child isn't genetically related to the mother. Success rates with egg donation are generally higher than when using your own eggs

3. Adoption

Adoption is another path to parenthood for those diagnosed with DOR. While it doesn't involve a genetic connection or the experience of pregnancy, it offers the opportunity to provide a loving home to a child in need.

Conclusion

DOR is a challenging diagnosis, but it doesn't have to mean the end of your dreams of parenthood. By understanding your condition, exploring your options, and working closely with healthcare providers, you can make informed decisions about your fertility journey.

Remember, DOR is a medical condition, not a personal failing. It's okay to feel frustrated, sad, or anxious about this diagnosis. Many women find it helpful to seek emotional support, whether through counseling, support groups, or open conversations with loved ones.

Ultimately, the path you choose will depend on your personal circumstances, values, and goals. Whether you decide to pursue fertility treatments, consider egg donation, explore adoption, or take a different route entirely, know that there are multiple ways to build a family and experience the joys of parenthood.

Your fertility journey may not look exactly as you imagined, but with perseverance, support, and the right medical guidance, you can navigate the challenges of DOR and move forward with hope and determination.

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Here’s how it works: our unique model empowers women to take control of their own reproductive health while giving you the gift of a lifetime. Our donors aren’t doing it for cash – they keep half the eggs retrieved for their own future use, and donate half to your family.

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• Human-centered. We didn’t like the status quo in egg donation. So we’re doing things differently, starting with our human-centered matching platform.
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We are obsessed with improving the family-building journey — today or in the future — and are in an endless pursuit to make these experiences more positive. Create a free account to get started today!