The number of eggs may be low, or the quality may be poor.

The number and quality of eggs (ovarian reserve) may begin to decrease at age 30 or even earlier. They decrease rapidly after age 40. But age is not the only cause. Abnormalities in the ovaries can also cause such a decrease.

Diagnosis and Treatment

Doctors may evaluate the following women for problems with eggs:

• Those who are 35 or older
• Those who have had ovarian surgery
• Those who have responded poorly to fertility drugs (such as gonadotropins) that stimulate several eggs to mature and be released

Doctors can usually confirm the diagnosis by measuring levels of a hormone that triggers ovulation (follicle-stimulating hormone) and estrogen in the blood at a certain time during the menstrual cycle. Sometimes doctors give women clomiphene, a fertility drug, before measuring these levels.

If women are older than 42 or if the number or quality of eggs is decreased, using eggs from another woman (donor) may be the only way to achieve pregnancy.

Last full review/revision October 2008 by Robert W. Rebar, MD