What is Diminished Ovarian Reserve | Dr Rama Sofat Hospital

What is Diminished Ovarian Reserve | Dr Rama Sofat Hospital

Dr Rama Sofat explains that diminished ovarian reserve (DOR) is a condition in which the ovary loses its normal reproductive potential, compromising fertility. The condition may result from disease or injury, but most commonly occurs as a result of normal aging.

What causes DOR?

As women age, their natural fertility potential begins to diminish. This phenomenon is universal and can be seen as early as age 30, becoming more pronounced over the next decade. 

Dr Rama Sofat provides details that typically, few women retain normal fertility by the time they enter their mid-40s. Because assisted reproduction does not reverse the changes in the eggs responsible for this decrease in fertility, success rates for patients undergoing IVF parallel the normal decline in natural fertility seen in the population at large. Illness or genetic abnormalities may accelerate this decline.

Cigarette smoking is one of cause of diminished ovarian reserve 

     Dr Rama Sofat discusses that the main causes of DOR :          

• Cigarette smoking.

• Genetic abnormalities .

• Aggressive treatments (radiation for cancer).

• Ovarian surgery, such as for endometriosis.

What are the symptoms of DOR?

Dr Rama Sofat provides details that unfortunately, most women exhibit no signs or symptoms of DOR. As the condition progresses over time, women may notice a shortening of the menstrual rhythm (e.g. 28 day cycles reduced to 24 days). Once menopause is imminent, women may notice signs of low estrogen such as hot flashes, trouble sleeping, missed menstrual periods and vaginal dryness.

Sleep trouble to woman

Diagnosis of DOR

Some women may see a shortened menstrual cycle, such as from 28 days to 24 days. But for the most part,women find out they have DOR after diagnostic testing. These include transvaginal ultrasound and hormone evaluations for follicle stimulating hormone (FSH), estradiol (a form of estrogen) and the anti-Müllerian hormone (AMH).

Dr Rama Sofat explains that FSH and estrogen are good indicators of fertility, as well as of a woman’s response to ovulation induction or stimulation, which can help her conceive. The anti-Müllerian hormone usually correlates well with fertility potential by reflecting the number of eggs left in the body.

How is DOR treated?

Dr Rama Sofat gives details that women with DOR who still want to conceive have options through assisted reproductive technologies.

When a woman is diagnosed with diminished ovarian reserve, she can take an immediate step and try fertility preservation. Fertility preservation involves retrieving a woman’s eggs from her ovaries and freezing them for later use that is called "Egg Freezing" process. The best time for women to freeze eggs is when they are young and their ovarian reserve is better.

Women can also use ovarian superovulation, which is an exaggerated form of ovulation induction. This treatment uses injectable hormones to induce the woman to ovulate multiple eggs. The eggs are then collected for cryopreservation or for use in a fresh IVF cycle to create an embryo and implant it in the woman’s womb.

Cryopreservation  Technique