Definitions and relevance: Diminished ovarian reserve, poor ovarian response, advanced reproductive age, and premature ovarian insufficiency

We have already presented proposed definitions for poor ovarian response (POR) and diminished ovarian reserve (DOR). Here, we describe another definition of ovarian reserve and its clinical relevance. In addition, per some authors, premature ovarian insufficiency (POI) may be a continuum of DOR. Hence, definition of POI has been tailored accordingly. These definitions in general reflect heterogeneity in presentation and treatment response of such patients. Advanced reproductive age cutoff per society and registry guidelines is at or above 35 years. The results of ovarian reserve tests may not predict fertility in the general population. This finding underscores the importance of oocyte quality, which can only be confirmed with a live birth outcome. Female age is still the most important biomarker for oocyte quality.