If AMH level is really really low and we, for example, can see the woman in menopause even if she is 30 years old and then, sometimes ovarian function may be restored for one or two months, in most of case we receive eggs of quite poor quality because on the process of maturation of egg take normally 150 days and a lot of follicle influence this follicle and egg growing and maturation and of course if there is no mostly follicles in ovary, all these processes are destroyed. This woman has a very high FSH level and it may also be that the growing main follicle may not be so correct with such a high FSH level. It may maybe so fast and egg may not mature enough so, yes, if we have very very low AMH level and really mostly zero ovarian reserve and time to time we have one follicle, in most of case, quality of eggs is decreased but if we have not so decreased ovarian reserve and receive two, three follicles, in most of case, the quality depends rather on age then AMH level.
It depends on when we can see the low ovarian reserve. If we will see this in a woman who is younger than 30 years old, then of course we have to deal with the normality of the eggs. So most of the eggs during that age, 75 percent of the eggs are normal. This means that although with the ovarian reserve the number of the eggs is diminished but on the other hand, most of them will be chromosomally normal so we do not have a decrease in success rates. On the other hand, when we have a low ovarian reserve in someone over 35 years old, we know it is something to expect. So we expect this decrease after this kind of age group but of course it also depends on how low the AMH is. AMH which is less than 1 nanogram per ml is extremely low, but even in this case, what we try to protect is the quality of the egg.
In this direction there is a way to do it through IVF treatment, natural conception as well, a lot of women are receiving through natural conception pregnancy, even with low ovarian reserves. But as the time passes and the low ovarian reserve decreases, there is a possibility of the eggs not being fertilised in a natural way. The wall of the egg becomes more thick or has other variations that do not allow for the sperm to penetrate normally. So as the ovarian reserve drops it does not mean that we cannot achieve pregnancy. It may perhaps be more difficult compared to a woman with satisfactory ovarian reserve.
It can. It can do if you are older but there’s so much we’re able to do now in terms of looking at the eggs and being able to do tests to determine the genetics of the embryos, so there are things that you can do but again sadly age has a big impact on this.
Yes, actually, ovarian reserve is a term that includes 2 different things which is quantity and quality. Of course, AMH speaks more about the quantity than the quality, but it tells us about how good those eggs are. So yes, low AMH will actually lead us to a conclusion of poor egg quality.
