Diminished Ovarian Reserve (DOR) is something every woman who wants to give birth should have a good understand of.
The reason is that DOR could have a direct impact on a woman’s potential to conceive and carry the baby to term.
Diminished Ovarian Reserve is a condition in which the ovary loses its normal reproductive potential.
Most importantly, when this potential declines and continues to decline, it could compromise fertility.
Causes Of DOR
Different things could cause DOR – from disease to injury – but it most commonly occurs as a result of normal aging.
At least 10 to 30% of women facing infertility issues are having DOR issues.
Unfortunately, ageing is something a woman cannot stop. Age must go up and when it comes to reproduction, age is not just a number.
As you age, your natural fertility potential begins to diminish.
Diminished Ovarian Reserve is a phenomenon that is universal. It shows up as early as age 30.
However, it becomes more pronounced as the woman approaches menopause.
Basically, the diminished reserve in women in their mid-40s can also affect chances of having a successful IVF.
Also, illness or genetic abnormalities may accelerate this decline.
Experts recommend that patients with DOR should undergo screening with a blood test for Fragile X Syndrome.
This is an inherited condition that leads to early ovarian failure, which is also responsible for the most common cause of inherited intellectual disability and autism (1).
Symptoms Of DOR
Sadly, most women who are having this condition show no signs or symptoms.
However, as the condition progresses, you may notice a shortening of your menstrual rhythm.
For instance, a 28-day cycle may reduce to 24-days.
Another sign of Diminished Ovarian Reserve is hot flashes which signifies that there is low estrogen level.
Other symptoms are missed menstrual periods, trouble sleeping, and vaginal dryness.
How To Diagnose DOR
One of the ways to know how sever the Diminished Ovarian Reserve is, is to go for blood test.
Blood samples obtained on the second or third day of the menstrual cycle would be used to measure the hormones FSH and Estradiol.
According to experts, FSH levels above a level of 12 mIU/mL are considered mildly elevated.
Levels above 15 mIU/mL are considered abnormal enough to cancel assisted reproduction attempts, since patients in this range will fail to satisfactorily respond to fertility-enhancing medications (2).
Also, fluctuations in the normal baseline expression of these 2 hormones indicate declining ovarian reserve.
Another blood test that can tell your fertility potential is the AMH (anti-Mullerian Hormone).
How Diminished Ovarian Reserve Affects Fertility
One of the issues with this condition is that it lowers a woman’s chances of conception and nurturing the foetus to term.
Studies found that DOR could cause miscarriages in women (2) (3).
Bear in mind that once you get to reproductive age, your body mechanism picks the healthier eggs first.
Indirectly, this means that each ovulation circle leaves you with older and less healthy eggs.
This diminishing condition continues all through a woman’s reproductive age.
This is why we recommend that a woman should do her best to marry early and also begin attempts to conceive early.
Is There A Treatment For Diminished Ovarian Reserve?
Unfortunately, there is no treatment that reverses the diminishing condition. However, there are a few things that can give hope.
One of the things to do is to cryo-preserve (freeze) eggs or embryos for a patient’s future use.
We are not so sure of how accessible and affordable such banks would be to women in Nigeria for instance.
The cost may be high if at all it is available. This is because constant light is necessary to keep the egg safe.
Another option which has a relationship with IVF is that you would have to receive higher doses of ovarian stimulation regimens.
Chances are that this will make the number of eggs harvested more effective.
Also, you may try donor egg, that is, getting egg from another individual.
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