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Poor Ovarian Reserve

Poor Ovarian Reserve

Poor Ovarian Reserve (POR) refers to a reduced quantity and often quality of eggs in the ovaries, which can affect fertility and response to stimulation. Management focuses on optimizing egg potential and offering appropriate fertility options.

Causes

  • Advancing maternal age
  • Genetic factors
  • Previous ovarian surgery
  • Endometriosis
  • Chemotherapy or radiation
  • Idiopathic (unknown causes)

Diagnosis

  • Anti-Müllerian Hormone (AMH) levels
  • Antral follicle count (AFC) on ultrasound
  • Day 2/3 FSH and estradiol levels
  • Clinical fertility history

Treatment Approach

Individualized Ovarian Stimulation

  • Tailored low- or high-dose stimulation protocols

  • Use of advanced stimulation strategies

IVF with Specialized Protocols

  • Mild stimulation or antagonist protocols

  • Double stimulation (DuoStim) in selected cases

  • Focus on quality rather than quantity of eggs

Adjunct Therapies

  • Nutritional and lifestyle optimization

  • Supplements such as antioxidants (as advised)

  • Hormonal priming in specific cases

 

Alternative Options

  • Egg donation for very low ovarian reserve
  • Fertility preservation planning when possible

Fertility Counseling

  • Realistic discussion of success rates
  • Emotional support and clear guidance
  • Planning timely treatment to maximize chances

Risks & Challenges

  • Poor response to stimulation
  • Cycle cancellation in some cases
  • Emotional stress

With early diagnosis, expert protocol selection, and compassionate counseling, women with poor ovarian reserve can still achieve pregnancy through individualized fertility treatment and advanced reproductive techniques.

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