For a long time, fertility problems were mostly linked to women in their late 30s or 40s. But doctors in India are now seeing a worrying change. More women in their 20s and early 30s are being diagnosed with diminished ovarian reserve (DOR), a condition that quietly reduces fertility, often without clear warning signs.
According to fertility specialist Dr Apurva Satish Amarnath from Nova IVF Fertility in Bengaluru, cases of low ovarian reserve among younger women are rising. She says many women come in with low AMH levels, fewer eggs, and sometimes irregular periods, even though they are otherwise healthy.
Ovarian reserve refers to the number and quality of eggs present in a woman’s ovaries. Unlike other cells, eggs are not produced throughout life. A woman is born with all the eggs she will ever have, and this number naturally declines with age. Usually, this decline becomes noticeable in the late 30s or early 40s. When it happens much earlier, it is called diminished ovarian reserve or early ovarian ageing.
What makes DOR challenging is that it often has no obvious symptoms. Many women feel perfectly fine and only discover the issue when they try to get pregnant. Doctors say that around 30–35% of infertility cases today involve low ovarian reserve. In severe cases, it can even lead to premature ovarian insufficiency, where ovarian function stops early.
Another concern is delayed diagnosis. Irregular periods in young women are often blamed on PCOS, which can cause doctors to miss ovarian reserve problems. Dr Amarnath explains that DOR can only be identified through specific tests such as AMH blood tests and ultrasound scans that count follicles in the ovaries.
Despite the seriousness of the condition, there is still hope. Dr Amarnath shared the case of a 26-year-old woman with very low ovarian reserve who was advised donor eggs elsewhere. After careful testing, doctors found one healthy egg. That single egg led to a successful pregnancy and a healthy baby.
Experts now strongly recommend early fertility check-ups, especially for women with irregular cycles, delayed conception, or plans to have children later. Early testing helps women understand their fertility status and explore options in time.
As doctors say, early knowledge gives women choices—and those choices can make all the difference.
