Primary Ovarian Insufficiency

Diminished ovarian reserve


Ovarian reserve reflects the quality and quantity of your eggs. Diminished ovarian reserve is a condition where the quality and quantity of remaining eggs is decreased. If this is the case, it makes getting pregnant more difficult.  It’s important to quickly and accurately diagnose diminished ovarian reserve in order to look at a variety of options for future parenthood.

Premature ovarian failure

In extreme cases, the egg supply is exhausted before age 40. This is referred to as premature ovarian failure. In most cases, if you have premature ovarian failure, you also have no menstrual cycles and have intermittent menopausal symptoms. Premature ovarian failure can be associated with serious health issues. This condition requires a more comprehensive investigation and treatment program.

Frequently asked questions

My doctor told me that I have decreased ovarian reserve and that my FSH test is elevated. Do I need egg donation to conceive?

Egg donation is certainly an option but not the only option. Not all women with an elevated FSH test require egg donation to conceive. Less costly options can be considered after a thorough evaluation. 

The cause of my infertility is unknown. Do I need testing?

The short answer is yes. Women with perfectly normal and regular menstrual cycles can have diminished ovarian reserve, which is directly linked to infertility.

What test is best?

There is no single test that can reliably predict reproductive potential. Our group endorses a panel of simple tests to evaluate reproductive potential. The results of these tests can be used to identify treatment options.

Do you perform IVF in women with an elevated FSH?

Not all women with an elevated FSH are candidates for IVF, but some are. Our group has had extensive and successful experience in treating women with diminished ovarian reserve.


  • Patton PE:  Infertility.  PORTLAND BABY RESOURCE GUIDE, 2nd ed., Auburn, CA: I’m Expecting.  1998.
  • Johnson A, Patton P, Titus S, Battaglia D, Burry K.  Defining the discriminatory FSH cut off in an IVF program.
  • Abstract P-5.  52nd Annual Meeting of the Pacific Coast Reproductive Society, April 28-May 2, 2004, Rancho Mirage, CA.  FertilSteril 2004;81(Supplement 3):S18.  Serono-PCRS Poster Award, which recognizes an outstanding poster presentation.FertilSteril 2004;81:18-19.
  • Annual Assembly of the New England Fertility Society:  Practice and Science Meeting, Stowe, VT, March 11, 2005.

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