Yes, of course, low ovarian reserve does not mean that women cannot become pregnant. It mean only that woman has less time to become pregnant, for example, 35 years old woman has ovarian AMH level 2.5 – it is normal, it is good and she can became pregnant till 40 more or less easily but if the same age 35 years old and woman has ovarian reserve 0.0 something it mean that probably mostly no eggs and if she will not become pregnant during six months or one year after her ovary will stop and no chance to became pregnant. So this is the main question.
If a woman can be pregnant with low ovarian reserve it depends mainly on her age group. So, for example, women who are 25 years old or 30 years old can still remain pregnant, very easily with low ovarian reserve as well unless we speak about extreme situations like premature ovarian failure. But when we have just a low ovarian reserve and we have a woman less than 30 years old, what matters is the quality of her eggs. So we know that in this age group, 75% of the eggs are normal and even if the number is lower, the normality of eggs is extremely high. On the other hand, if we have a low ovarian reserve in women more than 37, 38 or even 40 years old, then of course the possibility of pregnancy becomes more difficult. Doesn’t mean she cannot be pregnant. Becomes more difficult because we have to deal with another factor – the normality of the eggs, we have 75% of abnormal eggs so, not only we have the decrease ovarian reserve, these are more chromosomally abnormal than before but of course, it doesn’t mean that a woman with low ovarian reserve cannot be pregnant. It depends on the age group and it depends on underlying factors as well. So a woman with a low ovarian reserve that she has endometriosis, for example as well, it’s more difficult to conceive from another woman with low ovarian reserve and without endometriosis. So, it’s not one size fits all – it’s according to what we have to work with the age group and the underlying factors of course around it.
Yes, you can still get pregnant with low ovarian reserve. It’s really difficult because when a woman is told her egg reserves are really low, it sends into an absolute panic and she believes that this isn’t going to happen for her but it depends on how low they are and it depends on age – they’re the two biggest factors.
Yes, for us, ovarian reserve is one of the most important problems in Reproductive Medicine because it will give us the percentage of the success rate. When there is a better ovarian reserve there is a better success rate as we will have more and better quality oocytes. With lower ovarian reserves, the success rate will be lower because of these two reasons: the number of oocytes that a woman can have in her ovaries and the quality of those eggs.
This is a question I get asked from a lot of women particularly women who have tested their AMH and find it unexpectedly low. The truth is that the AMH or any reserve test shows how many eggs are in reserve. Having said that, every month we require one single egg to be released to be ovulated and therefore the reserve itself does not predict whether you’re able to get pregnant or not.
If your AMH level is low, you need to come and visit a fertility doctor as soon as possible. When you have a very low AMH level, there is a bit of possibility you will need to go for the oocyte donor program.
