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Chelsea Fertility NYC Blog

Understanding Diminished Ovarian Reserve and IVF

by Chelsea Fertility NYCPosted in InfertilityMay 26th, 2020

As women age, it becomes more difficult for them to get pregnant. This is because females are born with a limited number of eggs. By the time puberty occurs, the average female has approximately 300,000 to 400,000 eggs. With each menstruation, she loses about 1,000 immature eggs. By age 37, the average woman has about 25,000 eggs left in her reserves.

Women who have diminished ovarian reserve (DOR) have eggs lower than average in terms of both quantity and quality. Although getting pregnant can be more difficult when you have DOR, it’s not necessarily impossible, especially when using fertility treatments.

What Causes DOR?
DOR can be caused by a wide range of medical and lifestyle factors, including:

  • Endometriosis
  • Smoking
  • Autoimmune problems
  • Genetic abnormalities
  • Pelvic infection
  • Chemotherapy
  • Ovarian surgery

However, there may also be no immediately obvious cause for the condition.

What Are the Symptoms of DOR?
DOR can sometimes be difficult to detect because the symptoms aren’t necessarily noticeable. One of the main symptoms of DOR is difficulty conceiving, which is typically the symptom that causes women to seek fertility treatment. Some other symptoms include:

  • Shorter-than-average menstrual cycles
  • Heavy periods
  • Irregular menstrual cycles

If you have been trying to get pregnant for a while but haven’t succeeded, DOR could very well be the culprit and will likely be one of the first things a fertility specialist will test for.

How Is DOR Diagnosed?
DOR is typically diagnosed through ovarian reserve testing (ORT), which is also known as day-3 testing. ORT consists of blood work and ultrasound tests performed on the third day of a woman’s menstrual cycle. These tests measure the levels of follicle-stimulating hormone (FSH) and anti-Müllerian hormone (AMH), which are fundamental components of the female reproductive system. DOR is generally characterized by low levels of these hormones.

A transvaginal ultrasound is also performed to measure the uterus and ovaries. The ultrasound also measures the antral follicle count (AFC), which is a test where the egg follicles are counted.

DOR and IVF
In vitro fertilization (IVF) can be an effective treatment option for women who have been diagnosed with DOR. During an IVF cycle, injectable medications are used to elevate hormone levels and stimulate the ovaries so they produce and develop more eggs than usual. The eggs are retrieved and inseminated in a lab. Once an embryo develops, it is transferred into the woman’s uterus.

Women with DOR may also consider a treatment option known as intracytoplasmic sperm injection (ICSI). In this technique, a single sperm is isolated and injected directly into the egg. ICSI is especially useful when there are issues of egg quantity and quality.

To learn more about DOR and treatment options, contact Chelsea Fertility NYC today.