Committee opinion no. 618: Ovarian reserve testing

Abstract

The main goal of ovarian reserve testing is to identify those individuals who are at risk of decreased or diminished ovarian reserve, commonly known as DOR. Although ovarian reserve testing cannot predict the end of one's reproductive years, results outside the range expected for a patient's age can encourage the individual to pursue more aggressive treatment options to achieve pregnancy. Ovarian reserve testing should be performed for women older than 35 years who have not conceived after 6 months of attempting pregnancy and women at higher risk of diminished ovarian reserve. When test results suggest decreased or diminished ovarian reserve, if appropriate, an infertility evaluation should be initiated. It is reasonable to counsel the woman that her window of opportunity to conceive may be shorter than anticipated, and attempting to conceive sooner rather than later is encouraged. Compared with women of similar age, women with diminished ovarian reserve commonly have regular menses but a reduced quantity of ovarian follicles and, thus, may have a limited response to ovarian stimulation with fertility medications and reduced fecundity (probability of achieving a live birth in a single reproductive cycle). At this time, ovarian reserve testing results cannot be extrapolated to predict the likelihood of spontaneous conception.