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Understanding Low Ovarian Reserve

Low ovarian reserve (LOR) is a condition in which a woman has a diminished number of eggs or reduced egg quality. It is commonly diagnosed during the infertility workup and can help a patient understand their treatment options and chance of a successful outcome.

Causes And Risk Factors

The primary cause of LOR is age. As a woman ages, her ovarian reserve naturally declines. However, other factors can also contribute to LOR, including:

  • Genetic causes such as Fragile X premutation

  • Medical conditions such as premature ovarian failure or autoimmune disorders

  • Pelvic surgeries involving the ovaries

  • Pelvic radiation

  • Lifestyle factors such as smoking, excessive caffeine intake, and obesity

  • Environmental factors such as exposure to toxins and pollutants

Diagnosis And Testing

An accurate diagnosis of low ovarian reserve (LOR) is essential for developing an effective

Low Ovarian Reserve

fertility treatment plan. The following diagnostic procedures and tests are commonly used to assess ovarian reserve:

Blood Tests:

  • Anti-Müllerian Hormone (AMH): AMH is a hormone produced by the follicles in the ovaries. AMH levels can be used to estimate the number of eggs remaining in the ovaries.

  • Follicle-Stimulating Hormone (FSH): FSH is a hormone produced by the pituitary gland that stimulates the ovaries to produce follicles. Elevated FSH levels may indicate diminished ovarian reserve.

  • Estradiol: Estradiol is a type of estrogen produced by the ovaries. Estradiol levels can also be used to assess ovarian reserve.


  • Transvaginal Ultrasound and Antral Follicle Count (AFC): A transvaginal ultrasound is a minimally invasive procedure in which a probe is inserted into the vagina to image the uterus and ovaries. The ultrasound can be used to count the number of follicles in the ovaries which is a measure of ovarian reserve.

These tests can help your doctor determine the quantity of your remaining eggs. This information is very useful when deciding on a fertility treatment plan as it will predict how well the ovaries will respond to fertility medications.

Significance of Accurate Diagnosis

An accurate diagnosis of LOR is essential for making informed fertility decisions and for developing an effective treatment plan. If you are diagnosed with LOR, your doctor may recommend fertility treatments such as intrauterine insemination (IUI) or in vitro fertilization (IVF).

Early diagnosis of LOR can also help you and your partner make informed decisions about your family planning. For example, if you are diagnosed with LOR at a young age, you may want to consider egg freezing to preserve your fertility for the future.

If you are concerned about your ovarian reserve, please talk to your doctor. They can order the necessary tests and help you understand your results.

Implications For Fertility

LOR can reduce a woman's success rates when undergoing fertility treatments like IUI or IVF. The success of these treatments often relies on the ability to stimulate the ovaries to grow multiple eggs, which can be very challenging in patients with low ovarian reserve.

If you are considering fertility treatments, it is important to be aware that LOR can make it more challenging to conceive. However, with the right treatment plan, many women with LOR are able to achieve pregnancy.

Treatment Options

There are a number of fertility treatments available for women with LOR, including:

  • Intrauterine Insemination (IUI): IUI involves placing sperm directly into the uterus around the time of ovulation. This can be a good option for women with LOR who have partial tubal factor, mild male factor, or unexplained infertility.

  • In Vitro Fertilization (IVF): IVF is a more complex fertility treatment that involves fertilizing eggs with sperm in a laboratory setting. The resulting embryos are then transferred into the uterus. IVF can be a good option for women with LOR who have not been successful with other fertility treatments.

  • Donor Eggs Or Donor Embryos: If you are unable to conceive with your own eggs, you may consider using donor eggs or donor embryos. This can be a good option for women with LOR who have failed multiple IVF cycles or who have a genetic condition that they do not want to pass on to their child.

Your doctor will recommend the best treatment plan for you based on your individual circumstances and needs.

Lifestyle Changes And Supportive Care

While there is no cure for low ovarian reserve (LOR), there are a number of lifestyle changes and holistic approaches that may support ovarian health and overall fertility. These include:

  • Eat A Healthy Diet: A balanced diet is essential for overall health and well-being, including reproductive health. Eating plenty of fruits, vegetables, and whole grains can help to support ovarian function. It is also important to limit processed foods, sugary drinks, and unhealthy fats.

  • Maintain A Healthy Weight: Obesity can have a negative impact on ovarian function. Losing weight, even a small amount, can help to improve ovarian function and fertility.

  • Exercise Regularly: Moderate exercise can help to improve ovarian function and fertility. However, it is important to avoid excessive exercise, as this can have the opposite effect.

  • Quit Smoking: Smoking can damage the ovaries and reduce fertility. Quitting smoking can help to improve ovarian function and fertility.

  • Reduce Caffeine Intake: Excessive caffeine intake can interfere with ovulation and reduce fertility.

  • Manage Stress: Stress can have a negative impact on ovarian function and fertility. Finding healthy ways to manage stress, such as yoga, meditation, or spending time in nature, can help to improve ovarian function and fertility.

In addition to lifestyle changes, there are a number of support services, counseling, and support groups available for women and couples dealing with LOR. These resources can provide emotional support and guidance as you navigate your fertility journey.

Seeking Emotional Support And Professional Guidance

It is important to seek emotional support during your fertility journey. Talking to a trusted friend or family member, a therapist, or a support group can help you to cope with the emotional challenges of LOR and fertility treatment.

Professional guidance can also be helpful. A fertility specialist can help you to understand your options, develop a personalized treatment plan, and support you throughout your fertility journey.


Low ovarian reserve is a common diagnosis made during the infertility workup, but it does not mean that you cannot have a child. With the right diagnosis, treatment plan, and support, many women with LOR are able to achieve pregnancy.

If you are concerned about your ovarian reserve, you are not alone in your journey. Audubon Fertility is here to support you every step of the way. We offer comprehensive diagnostic and treatment options, as well as emotional support and guidance. Please visit our website to learn more about our services and to schedule a consultation.


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