What is Diminished Ovarian Reserve?
Diminished Ovarian Reserve (DOR) is a decrease in the number and quality of the remaining eggs in the ovaries, or a poor response to ovarian stimulation. It’s usually measured by AMH and FSH levels, and antral follicle count via ultrasound.
Often fertility doctors will recommend an egg donor as the only solution.
What I want you to know is that that may not be your only choice.
Can you still get pregnant with Diminished Ovarian Reserve?
Here's why you shouldn't be freaked out if you've been told you have diminished ovarian reserve, and why there's absolutely still hope.
There has been little-to-no data demonstrating that these hormone levels (FSH and AMH) have any correlation with natural fertility for women. They do tell doctors how well you will respond to IVF stim medications, but they do not necessarily indicate your ability to get pregnant naturally.
A study done in 2017, published in JAMA, entitled “Association Between Biomarkers of Ovarian Reserve and Infertility Among Older Women of Reproductive Age” that followed 750 women over a year showed that women who had low AMH levels didn’t differ in their ability to conceive from women with normal AMH levels and, similarly, women with high FSH levels didn’t differ significantly from women with normal FSH levels.
It’s common for women to hear they have diminished ovarian reserve and be devastated, assuming this is a “diagnosis” of infertility. Low AMH likely does mean they would have a harder time retrieving a lot of eggs in an IVF retrieval but, based on the information in this study and based on what I see in my clinic and with my fertility clients, you should not assume that this means you won’t be able to get pregnant naturally.
What to do to get pregnant with diminished ovarian reserve
While you can’t increase the number of eggs you have stored in your ovaries, you CAN improve your ovarian function and egg quality. While AMH is harder to improve, I see FSH lower and improve all the time. Women still have 500-1000 eggs left at the time they enter menopause. Egg quality is far more important than egg quantity. This is what I would focus on. Go check out my video on Egg quality.
And this is what The Becoming Mama program is designed to do - to boost your egg quality and restore your fertility holistically.
I would recommend giving it 4 months, following all the guidelines, and trying again after that, before jumping into an egg donor cycle if you don’t feel ready or inclined to jump to a donor. There is hope.
I hope you have a beautiful day, and remember, your fertile health is a daily practice.