Diminished ovarian reserve in women over 40

Ovarian reserve refers to the remaining supply of eggs and their response to stimulation. Assessment may include an anti-Müllerian hormone blood test, antral follicle count on ultrasound, and other fertility tests. A lower result can suggest fewer eggs available for treatment, while a result in the expected range does not measure egg quality or guarantee conception. Age also affects egg quality and pregnancy outcomes, so reserve testing should be interpreted alongside menstrual history and the wider fertility assessment.

If pregnancy is a goal, arrange fertility advice rather than relying on a single home test or laboratory value. Take a record of cycle dates, previous pregnancies, surgery, pelvic infections, and medicines. Ask about ovarian reserve testing, partner assessment, and options such as trying to conceive, assisted reproduction, or using previously stored eggs. A clinician can explain what each option involves, including medication, monitoring, retrieval, and emotional considerations. Do not delay an appointment because periods are regular; regular cycles do not measure egg reserve.

Seek fertility advice promptly if you are over 40 and want to become pregnant, especially if cycles are changing, periods are absent, or there is a history of ovarian surgery, chemotherapy, endometriosis, or early menopause in the family. Contact a clinician for severe pelvic pain, heavy bleeding, or sudden symptoms after fertility medication. An ovarian reserve result that concerns you deserves an explanation, but it is not an emergency by itself.

Ask: Which reserve tests are appropriate for me? How should my result be interpreted with my age and cycle history? What does the test not tell us? Should my partner be assessed now? Which options preserve time and what are their risks?