Diminished Ovarian Reserve
Female fertility declines significantly starting at age 35, by age 42 pregnancies are rare. Along with the decline in fertility (chance of pregnancy), there is an increased risk of miscarriage, so that by age 42 more than half of all pregnancies end in miscarriage. Fertility treatments do not reverse this process. So while we are able to help many patients in the older reproductive age group, success rates are lower. At Walter Reed we do not perform IVF for women 42 years of age or older.
In addition to age, measuring day 3 and sometimes day 10, FSH values help us predict how well the ovaries will respond to stimulation medications. Sometimes levels of another hormone, AMH, are also used. If these values are markedly abnormal, and indicate that there is little chance of the ovaries responding to the IVF medications, we may decide not to offer an IVF cycle.
Elevated hormone levels, or a diagnosis of “diminished ovarian reserve” do not mean that you cannot get pregnant spontaneously, or that you will undergo menopause at an earlier age. It simply means that while the ovaries may function normally inasmuch as they produce an egg every month, they do not have the “reserve” to be stimulated to produce multiple eggs, an essential part of the IVF procedure.