GDF9 and Infertility: These mechanisms explain why the presence of some GDF-9 polymorphisms may influence the ovarian reserve, since they have been associated with diminished ovarian reserve (DOR), poor response after ovarian stimulation, and poor IVF outcome in studies comparing women with infertility and females with a normal ovarian reserve (Wang et al., 2010; 2013; Greene et al., 2014).