What is diminished ovarian reserve, and why does it make it hard to conceive on your own?

Theresa

As a woman ages, her fertility decreases. This decrease occurs slowly up until about 35 years of age, when fertility falls even faster. This drop in fertility is seen even in women who have perfectly normal, regular menstrual cycles. In fact for some women, fertility may no longer be possible five to 10 years before menopause. Diminished fertility, also called diminished ovarian reserve, is thought to reflect both a decreased number of eggs and a decrease in egg quality.

To test for diminished ovarian reserve, doctors use the clomiphene challenge test and day 3 FSH testing. This involves measuring your levels of the hormones FSH and estradiol on the third day of your cycle. Then, from day 5 through day 9, you take 100mg clomiphene (two tablets) each day. A day or two later, FSH level is measured again. If the FSH value is high, that indicates your fertility potential is diminished due to age. Values of FSH above 10 indicate that you may have difficulty conceiving or carrying a pregnancy. Values over 14-15 indicate that your chance of success would probably be nil without egg donation and in vitro fertilization (IVF).