THE DETECTION OF DIMINISHED OVARIAN RESERVE IN INFERTILE WOMEN

Women in their mid to late 30s and early 40s with infertility constitu te the largest portion of the total infertility population. These wome n frequently undergo multiple testing, and most will require expensive and invasive therapies, including assisted reproductive technologies, with markedly reduced pregnancy rates in those older than 40. These w omen also have a higher incidence of pregnancy loss even after documen tation of fetal cardiac activity by ultrasonography. Identifying those women who have a very low chance of pregnancy land a high chance of p regnancy loss) with their own gametes presents a daily challenge to th e practicing clinician, especially before embarking on expensive treat ments. This article reviews the contemporary investigation of reproduc tive aging with basal and provocative tests. Women with markedly dimin ished ovarian reserve should be counseled on their low chances of conc eption with their own gametes, even with assisted reproductive technol ogies.