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.
We have to consider the age group. Low AMH under the age of 35 years old is not a predictor about the outcome of the fertility treatment but AMH can give us information for these group of women less than 35 years old for other situations like Polycystic Ovarian Syndrome that we have extreme levels of AMH, it is another indication for egg freezing process because in this kind of treatment we need a number of eggs. AMH cannot give us the answer after 35 years old if the women can become pregnant or not, so it is not a predictor. Can be a predictor if it is in extreme ages when we have age when we can see lower follicle count and low AMH. Of course, there is some consensus of the European Fertility Society about the poor responders and of course in this consensus and the criteria that we use, the AMH plays the main role as well. We speak about poor responders when we have low AMH, low antral follicle count, we have less than 3 follicles collected in one fertility treatment but it is not the only predictor. Needs to be related to the age group that the woman belongs to. Basically, the AMH cannot give us a clear answer about the quality of the eggs. Can give us the clear answer about the situations when we need a number of eggs like the egg freezing, polycystic ovaries -situations when we need numbers. Of course, on the other hand, it is a very good tool for specialists to adjust the dose of medication when we do an ovarian stimulation. Can give us information perhaps about what we expect from the IVF cycle or the ovarian stimulation but it is not an absolute predictor about the outcome of fertility and quality of the eggs.
It’s interesting, isn’t it? Because AMH, over the last sort of like eight to ten years, has become the marker to assess a woman’s fertility. What it means obviously, it’s a blood test, it’s a hormone that’s present in the ovary and gives us a good idea about the likelihood of something like IVF working. If it’s very very low and a woman is older, the chances of her starting IVF, getting through a cycle to the finish line, to have her eggs collected is much much lower, so she might have to make a decision about not doing IVF but looking at moving on to other options such as egg donation but you never say never because we see all sorts of things that happen and fertility isn’t black and white there’s so many shades of grey.
It means a lot because it is one of the three basic points that we have to understand the ovarian reserve.
We spoke earlier about the Antral Follicle Count and a woman’s age. AMH is a hormone that tells us more about the quantity than the quality, but it includes both aspects. So AMH is really important for us to know how the ovarian reserve is and to see how well we are going to do with an IVF procedure.
