Ovaries are the female organs that age more quickly than other tissues such as the uterus, the pituitary gland or pancreas. Different from males, an interesting question is why and how the females lose fertility so rapidly. During the aging process, both the number and quality of the oocytes in the ovaries decrease and reach to a point beyond that no more viable offspring may be produced and the associated cyclic endocrinological activities cease, entering the menopause in females at an average age of 50 years. Females who delayed childbearing with or without their willing until their 30 years or 40 years constitute the largest portion of the total infertility population. OVARIAN RESERVE tests (ORTs) provide an indirect estimate of a female’s diminishing OVARIAN RESERVE or remaining follicular pool. This article briefly re-views recent progresses in relation to OVARIAN aging and ORTs.

The standard goal of all fertility treatments is the improvement of pregnancy rates in infertile patients. Within the last 20 years, ovulation induction has contributed to the success of assisted reproduction techniques e.g. in vitro fertilization (IVF) and embryo-transfer (ET). The efficacy of these techniques depends on a personalized protocol of controlled OVARIAN hyperstimulation (COH) and adequate oocytes recruitment. The response to common OVARIAN stimulation protocols is not always as expected. Failure to respond adequately to standard protocols and to recruit adequate follicles is called 'poor response' in these patients although it is highly correlated with age. However, in younger women it might be associated with advanced endometriosis or prior OVARIAN surgery, gonadotoxic chemotherapy, OVARIAN radiation, pelvic infection and certain genetic conditions (including mosaic turner syndrome, FMR1 pre-mutation carriers) which are common causes of diminished OVARIAN RESERVE (DOR). Several tests have been suggested but none of them has significant value to predict DOR. Furthermore, an accurate diagnostic test of low OVARIAN RESERVE would help the clinicians to use the most suitable COH protocol and resulted in declining the cost and psychological decay. However, the ideal stimulation for diminished OVARIAN RESERVE still is great challenge for the clinician and patient.