This page explains how Diminished Ovarian Reserve (DOR) relates to IVF treatment. All information is educational. Talk to your reproductive endocrinologist about how this condition may affect your specific situation and treatment plan.
What is Diminished Ovarian Reserve?
Diminished ovarian reserve (DOR) means that the number of eggs remaining in the ovaries is lower than expected for a person of their age. It is typically assessed through AMH (anti-Mullerian hormone) blood tests, antral follicle count (AFC) on ultrasound, and day 3 FSH levels. DOR does not necessarily mean infertility, but it can affect how many eggs are retrieved during an IVF cycle.
How common is it?
DOR affects approximately 10 to 15 percent of infertile patients. It is more common with age, but it can occur in people in their 20s and early 30s as well, which can feel particularly devastating.
How DOR affects IVF
People with DOR typically produce fewer eggs in response to stimulation, even with maximum doses of gonadotropins. This means fewer eggs available for fertilization and fewer embryos to select from. Retrieval cycles may yield 1 to 5 eggs rather than the typical 8 to 15. Quality matters more than quantity, and even a single healthy embryo can lead to a successful pregnancy.
Typical IVF approach
Maximum stimulation protocols with high doses of FSH and sometimes LH (such as Menopur). Microdose Lupron flare protocols or antagonist protocols are common. Supplements like DHEA and CoQ10 are often recommended before cycling, though evidence is still developing. Your doctor may recommend testing multiple cycles or mini-IVF depending on your response.
Factors that support success
- Egg quality remains the most important factor, even when quantity is low
- Preconception supplementation (DHEA, CoQ10) may be recommended to support egg quality
- Maximizing stimulation while monitoring closely to prevent cycle cancellation
- Genetic testing (PGT-A) on embryos, when quantity allows, may improve transfer success rates
- Emotional preparedness for the possibility of low egg yield and potential canceled cycles
Your emotional experience matters
The medical side of infertility is only part of the story. Here is what many people in the IVF community want you to know about the emotional side of this diagnosis.
- Receiving a DOR diagnosis can feel like time is running out. Those feelings are valid and understandable.
- Low egg counts at retrieval can be emotionally devastating, especially when you have prepared so carefully.
- Many people with DOR have had successful pregnancies. One good egg can be enough.
- Connecting with others who have experienced DOR can provide real support that goes beyond statistics.
- It is okay to grieve the diagnosis while also holding space for what is still possible.
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Can I still get pregnant with diminished ovarian reserve?
Yes. While DOR presents challenges by reducing the number of eggs available, many people with DOR have conceived with IVF. Egg quality is not determined by AMH or AFC alone. Your doctor can advise on strategies to optimize your specific situation.
What does a low AMH mean for IVF?
AMH (anti-Mullerian hormone) reflects the size of your remaining egg pool. A low AMH suggests fewer eggs available to retrieve, which may require more cycles or a different stimulation approach. AMH does not directly measure egg quality, and success stories exist across a wide range of AMH values.
Should I take DHEA or CoQ10 for DOR?
Some reproductive endocrinologists recommend DHEA or CoQ10 supplementation for people with DOR based on limited but promising evidence that they may support egg quality. Discuss this with your doctor before starting any supplement, as DHEA in particular is a hormone precursor and dosing matters.
What happens if my IVF cycle is canceled due to poor response?
A canceled cycle is emotionally devastating, and it is completely understandable to feel grief, frustration, and fear. Poor response does not permanently close the door. Your doctor will review your protocol and may adjust the approach for a future cycle. Some patients benefit from switching to a different stimulation protocol.
Medical disclaimer: This page provides general educational information only. It is not medical advice and should not replace guidance from your doctor, nurse, or reproductive endocrinologist. Every person's treatment is unique. Always consult your care team before making any decisions about your medications or treatment plan.
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About the author
Viv
BSc, Patient Advocate
Founder, TrackMyIVF
I built TrackMyIVF because I needed it during my own journey. Every feature comes from real experience.