Women with a diminished ovarian reserve (DOR) have one or more ovaries that do not contain as many oocytes as expected for the woman’s age. The term ovarian reserve refers to the overall quality and number of remaining eggs. There are several tests that can be utilized to test ovarian reserve or egg quality and often more than one test will be performed by a Denver fertility specialist to get the best evaluation possible of the egg quality. The most common ovarian reserve testing involves measuring the blood level for follicle-stimulating hormone, estradiol and antimullerian hormone. As the egg quantity decreases, the follicle-stimulating hormone or FSH increases. FSH levels keep rising until the egg supply is completely depleted. Menopausal women have a significantly high levels of FSH. Additionally, as egg quality declines the basal estradiol level on day 2, 3 or 4 of the cycle will rise. A level greater than 80 pg/mL, on day 2 , 3 or 4 is considered abnormal and associated with low fertility potential. The antimullerian hormone level is the most common test performed by fertility specialists and seems to be most predictive of fertility and menopausal age. The AMH level declines as one ages and a level below 2.0 ng/ mL is associated with decreased fertility.
Other tests to check for diminished ovarian reserve include an antral follicle count. This is a count of the resting number of eggs in the ovary and a count of 10 or more is considered normal. The Antral follicle count is done by ultrasound evaluation of the ovaries. Of course the higher the count the better your fertility potential is. It is important that this test is done by a fertility specialist who has experience in evaluating the ovaries for an Antral follicle count.
FSH stimulates cells around the ovary to increase estrogen production. As the estrogen levels go up, FSH production is stopped. This is considered to be a normal process. However, with an aging egg, the ability to produce estrogen and the hormone inhibin is slowed, therefore FSH levels are higher.
Certain tests are performed with a Colorado reproductive endocrinologist in order for there to be an identified diagnosis of diminished ovarian reserve.
What Causes Diminished Ovarian Reserve?
Diminished ovarian reserve, aside from aging, can be brought on by damage to the ovaries from disease or poor health. Older age is the number one cause of diminished ovarian reserve followed by smoking as the number two cause of diminished ovarian reserve. Lastly, a lot of women experience DOR from damage to the ovary by disease or surgery. Endometriosis is the most common disease that results in diminished ovarian reserve. Surgery for ovarian cysts can also contribute to ovarian tissue damage resulting in diminished reserve.
Approximately 1% of women transition to menopause by the age of 40, which can affect the rate of conception. Based on the blood level of FSH for women who want to get pregnant, treatment is available to assist with diminished ovarian reserve at a fertility clinic in Denver.
Treatment for Diminished Ovarian Reserve
Treatment options for women with diminished ovarian reserve is limited. Success depends on the degree of damage to the ovary and the blood levels of the female hormones. If you have DOR it is important to seek treatment at a fertility clinic in Denver. More tests may be performed with a Colorado reproductive endocrinologist in order to determine the cause and best treatment of the DOR.
Your Denver fertility specialist can help you decide which method of treatment is best suited for your age, condition and promises the highest success rate for pregnancy. If you have questions concerning your fertility, or have failed to get pregnant over the course of one year see a specialist right away to determine what treatment is available.
Dr. Deborah Smith was recently named the Top Fertility Doctor in Colorado by Health Tap. For over 20 years, she has been treating patients with comprehensive options to help women achieve their fertility goals. Currently, the practice is offering a complimentary 15 minute phone consultation, simply call (303) 999-3877 for more information and scheduling.