Diminished Ovarian Reserve (DOR) is a condition indicating a woman's natural reserve of eggs has significantly reduced. This is a process that does normally occur for a woman as she grows closer to menopause, but it can occur in a woman of much younger age. When this occurs, conceiving becomes difficult for a woman as her ability to produce healthy eggs begins to diminish.
When a woman is diagnosed with DOR (high baseline FSH, low antral follicle counts and/or low AMH), most often she is told her chances of conceiving a biological child are very slim and that common infertility treatment, such as IVF, may also not be successful. Most of these women are told their only option is to seek out donor egg to help her successfully achieve a pregnancy.
Here at Life IVF Center we believe and support every woman in having a chance to conceive a child with their own eggs, even if she has DOR. Our treatment protocol for women with DOR is unlike other IVF clinics using conventional IVF approaches. In most other clinics they apply high dosages of gonadotropins, such as Gonal F, Follistim and Menopur, to overcome the ovaries' poor response. However, women with DOR usually already have high levels of FSH, if you give her gonadotropin injection, it will only makes FSH level go higher. When FSH level is too high, all follicular FSH receptors will be saturated, then no follicle will grow. This is why many clinics will cancel a woman's cycle and tell her she is a poor responder.
Our treatment here at Life IVF Center does not focus on the use of high dose gonadotropins, rather we focus on the woman's individual cycle and create customized personal treatment plans. Depends on her baseline Estradiol, FSH level, and her antral follicle counts, we may choose Natural Cycle IVF or Minimal Stimulation IVF protocols.
For patient with DOR, but her FSH level is between 12-20 and with several antral follicles, we may consider use Minimal Stimulation IVF. These patients may respond well with Clomid and low dose gonadotropin injections.
For patients with FSH level between 20-30, we may consider doing Natural Cycle IVF. With Natural Cycle IVF, we can monitor a woman's follicular development. When follicle is ready to ovulate, we then schedule for her egg retrieval.
For women with extremely high FSH level, very often the follicle will not grow due to high level of FSH, in these patients we may have to use medication to lower her FSH level to allow follicle grow. The most commonly used medications are Estradiol and low dose birth control pills.
We have found great success treating women with DOR and believe every woman should be given a chance to conceive with their own egg. We have helped a woman conceive biological twins with her own eggs where her highest FSH level reached 99 during a cycle. We also helped a woman with severe endometriosis and FSH level of 70 to conceive a child in the same cycle. To learn more about our treatment protocols and options at Life IVF Center, please attend one of our free IVF Seminars for more information.