Diminished ovarian reserve (DOR) is a condition in which the ovary loses its normal reproductive potential, compromising fertility. The condition may result from disease or injury, but most commonly occurs as a result of normal aging. DOR is present in 10-30% of patients presenting to doctors with infertility.
Advanced reproductive age, particularly over the age of 40, puts women at risk for DOR. Previous injury to the ovary due to diseases such as endometriosis, pelvic infection, or iatrogenic damage caused by pelvic radiation, chemotherapy or surgery further increases risk.
Unfortunately, most women exhibit no signs or symptoms of DOR. As the condition progresses over time, women may notice a shortening of the menstrual rhythm (e.g. 28 day cycles reduced to 24 days). Once menopause is imminent, women may notice signs of low estrogen such as hot flashes, trouble sleeping, missed menstrual periods and vaginal dryness.