Causes & Treatment

Diminished ovarian reserve – symptoms, causes and groundbreaking treatment

Eloise Edington  |   8 Dec 2022


Diminished ovarian reserve affects around 10 per cent of women seeking fertility treatment, according to The National Center for Biotechnology Information (NCBI). This makes it as common as conditions like PCOS and endometriosis, but for people looking to build their chances of conception using their own eggs, treatment options can be relatively limited. 

What is diminished ovarian reserve? 

Diminished ovarian reserve (also known as DOR or low ovarian reserve) is a relatively common cause of infertility, where the ovary begins to lose (or entirely loses) its reproductive function. With DOR, patients often find they have a lower egg count, and/or eggs which are lower in quality. 

DOR can affect people of any age, but usually occurs as we enter menopause. Your doctor or fertility team will usually use hormone testing and ultrasound to assess your ovarian reserve, and make a diagnosis. 

Is diminished ovarian reserve treatable?

Until very recently, the medical community has filed DOR as an ‘untreatable’ condition. Success stories are published more as small miracles, than consistent, conscious medical achievements.  Fertility teams will usually move straight to egg freezing and IVF with your own eggs, or donor eggs, to help you achieve a pregnancy with a DOR diagnosis. 

But advances in rejuvenation are challenging the traditional thinking, as we step into 2023. 

The SEGOVA Program, developed by the pioneering team at SEGOVA Biotechnology, is poised to transform the prognosis of diminished ovarian reserve for patients across the globe. Using cutting-edge ovarian rejuvenation treatment, it works to create the elements we need – using our own existing tissue – to produce new egg cells and proper endocrine function. 

Highly advanced, innovative and safe, the SEGOVA Program is run by a specialist team. And there’s no-one better placed to dive into our diminished ovarian reserve 101, answering your top questions. From symptoms and the diminished ovarian reserve AMH connection to causes and success stories, here’s everything there is to know about DOR.

Diminished ovarian reserve symptoms 

Infertility is a key DOR symptom. And many, many people won’t have any other symptoms – or if they do, they can be sporadic and hard to pin down. Here are the signs of diminished ovarian reserve we commonly see with our patients: 

  • infertility, and/or miscarriage 
  • shortening menstrual cycles
  • perimenopause symptoms (such as irregular periods, vaginal dryness, hot flashes, etc)
  • heavy periods
  • low AMH levels (see below)

Again it’s important to bear in mind that you may not have all – or any – of these symptoms, other than difficulties having a baby. So do speak to a fertility or specialist DOR team – their expert opinion and quick diagnosis could prevent months, or even years, of uncertainty.

Diminished ovarian reserve causes – is it my age?

DOR tends to be connected to a woman’s age. However, it affects at least 10 per cent of women dealing with infertility, and in reality age is not the only factor. DOR can be seen as early as age 30 (earlier, in some rare cases). 

In general, a woman in her mid-40s will almost definitely see reduced fertility. Earlier than age 40, diminished ovarian reserve causes can include: 

  • premature ovarian failure (early menopause, affecting around one per cent)
  • tubal disease, pelvic infection, or mumps
  • endometriosis
  • injury
  • use of specific medical treatments (e.g surgery, or cancer treatment)
  • autoimmune conditions
  • Fragile X Syndrome (which can cause premature ovarian failure)
  • other genetic abnormalities
  • smoking, and tobacco use 

And sometimes, mirroring so many areas of infertility, there’s no clear cause. 

The diminished ovarian reserve AMH connection

Anti-Mullerian hormone (AMH) is produced by the cells inside your ovarian follicles. It’s very often part of the panel of tests run by a fertility team, as an indicator of your ovarian reserve. 

In real terms, an AMH test can tell us a lot about your egg count – low AMH levels often indicate diminished ovarian reserve. 

But again, it’s not an exact science. Patients do present with low AMH but good DOR (or the other way around), and it’s important to remember, your AMH level isn’t an indicator of the quality of your eggs. Doctors often use AMH as a way to judge the dosage for egg production stimulating medications, and to predict (not confirm) your egg count. 

Success stories 

It is absolutely still possible to get pregnant with DOR. This is a widely misunderstood area of fertility medicine, and not an automatic end to the road, for your fertility journey, or the trigger for IVF with donor eggs. It’s true that early diagnosis helps, because it gives your team a wider window to find the right treatment, and potentially help you conceive using your own, healthy, eggs.

The SEGOVA Program is right at the edge of pioneering DOR research, and treatment. Access up-to-the-minute information about how it works, and connect with our team for next steps. But first, watch SEGOVA patient Anita Savic run through her wonderful success story, from a hormonal imbalance and premature menopause diagnosis to natural conception seven months later. 

Contact the SEGOVA team today, to talk through DOR, fertility queries and your TTC journey so far. They’re poised to help you take the next steps, with pioneering biotechnology.

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