Overview

Every woman is born with a fixed number of eggs that declines over time — accelerating after 35. DOR means the quantity or quality of remaining eggs is lower than expected for age. Many women with DOR do conceive with specialist support.

Symptoms

• Often no obvious symptoms
• Shorter cycles (less than 26 days)
• Lighter periods
• Difficulty conceiving after 6–12 months
• Poor response to IVF stimulation

Causes & Risk Factors

• Age — the most significant factor
• Family history of early menopause
• Previous ovarian surgery
• Chemotherapy or radiotherapy
• Endometriosis, especially ovarian endometriomas
• Smoking — accelerates egg loss
• Autoimmune conditions

Diagnosis

• AMH — most reliable marker; tested any day of the cycle
• Antral Follicle Count (AFC) — transvaginal ultrasound, days 2–5
• Day 3 FSH — elevated levels suggest reduced reserve
• Oestradiol (E2) — interpreted alongside FSH

Treatment

• IVF with individualised protocols (e.g., POSEIDON for poor responders)
• Mini-IVF or natural-cycle IVF for very low reserve
• Egg freezing — strongly recommended for younger women diagnosed early
• PGT-A — to select chromosomally normal embryos
• DHEA and CoQ10 supplementation — may improve egg quality
• Lifestyle optimisation — stop smoking, healthy weight

Worried about your egg supply? Book a consultation today