Diminished Ovarian Reserve
Conditions

Diminished Ovarian Reserve
What It Means & What to Do

A low AMH result is not a diagnosis of infertility. It measures quantity — not quality. Here is what the research actually says, and what you can do in the 90-day window before retrieval.

Reframe the Diagnosis →
AMH
measures quantity only — not egg quality
90 days
window to improve the quality of remaining eggs
DHEA
shown to improve egg numbers in DOR patients
CoQ10
ubiquinol 600–800 mg/day supports mitochondrial function

Reframing the Diagnosis

What the evidence actually says about diminished ovarian reserve and fertility.

DOR Is About Quantity, Not Quality

Anti-Müllerian hormone (AMH) and antral follicle count (AFC) measure the number of remaining follicles — they say nothing about the quality of those eggs. Women with very low AMH conceive naturally and through IVF every day. The egg that fertilises and implants is a single egg — and its quality is shaped by the 90-day maturation window, not by how many others remain.

The 90-Day Window Still Applies

Every egg that will be retrieved or ovulated in the next 90 days is currently in its final growth phase. The mitochondrial energy capacity, antioxidant protection, and chromosomal integrity of those eggs can be meaningfully influenced by nutrition, supplementation, and lifestyle in the window before retrieval or conception.

IVF Outcomes With DOR

Women with diminished ovarian reserve (DOR) typically produce fewer eggs per IVF cycle, but egg quality — and therefore live birth rates per retrieved egg — is not necessarily lower than age-matched women with normal reserve. The clinical focus shifts from maximising egg numbers to maximising the quality of the eggs retrieved.

Supplement Protocol for DOR

Discuss all supplements with your specialist before starting.

CoQ10 (ubiquinol)
600–800 mg/day
Supports mitochondrial ATP production in oocytes; most studied supplement for DOR. Ubiquinol form has superior bioavailability. Begin 90 days before retrieval.
DHEA
25–75 mg/day (practitioner-guided)
Dehydroepiandrosterone (DHEA) is a precursor to androgens and oestrogens. Supplementation for 3–6 months before IVF has shown improved egg numbers and quality in DOR patients in multiple studies. Requires practitioner supervision — can worsen PCOS.
Melatonin
3 mg at night
Acts as an antioxidant within follicular fluid, protecting oocytes from reactive oxygen species. Levels in follicular fluid correlate with fertilisation rates.
Vitamin D3
Target 100–150 nmol/L
Vitamin D receptors on granulosa cells regulate follicular development. Deficiency is associated with reduced IVF response in DOR patients.
Omega-3 (DHA/EPA)
2 g/day
Reduces follicular fluid inflammatory markers; supports oocyte membrane integrity and mitochondrial function.
Myo-inositol
2–4 g/day
Improves oocyte quality and reduces FSH requirements in poor responders; supports insulin signalling in granulosa cells.
Your Action Plan

DOR Optimisation Checklist

0/17 completed

Understanding Your Results

Ask your specialist: 'What does this AMH level mean for my specific situation?'
Request antral follicle count (AFC) ultrasound alongside AMH — AFC gives a direct visual count
Understand that AMH fluctuates — retest if result was unexpected or taken during illness
Ask about your clinic's specific DOR protocol — stimulation approach differs from standard IVF
Request your Day 2–3 FSH alongside AMH — elevated FSH confirms reduced reserve

Supplement Protocol (90 Days Before Retrieval)

Start CoQ10 (ubiquinol) 600–800 mg/day — begin as early as possible
Discuss DHEA supplementation with your specialist — 25–75 mg/day for 3–6 months
Add melatonin 3 mg at night
Check and optimise Vitamin D — target 100–150 nmol/L
Add omega-3 DHA/EPA 2 g/day
Consider myo-inositol 2–4 g/day

Lifestyle Optimisation

Eliminate alcohol — directly toxic to oocytes
Prioritise sleep 7–9 hours — melatonin production peaks during deep sleep
Reduce high-intensity exercise — moderate movement only
Adopt anti-inflammatory Mediterranean-style diet
Manage psychological stress — cortisol impairs granulosa cell function
Avoid environmental toxins: plastics, pesticides, synthetic fragrances (see Detox Audit guide)
← Back to Resource Hub