What is poor ovarian reserve?

Question of the day: “I was told that I have poor ovarian reserve, what does it mean?”

Hi, this is Dr. Kay Waud of Dominion Fertility. If you have been told you have poor ovarian reserve, you may be wondering what it means. It is very common for our patients to present to their first visit at Dominion Fertility with prior fertility testing. One of the goals of a fertility evaluation is to assess ovarian reserve. Your doctor may have checked the levels of anti-mullerian hormone (AMH) or follicular stimulating Hormone (FSH) in your blood. Alternatively, she may have performed a study utilizing transvaginal ultrasound to assess how many follicles you have available during a given cycle. Any of these three tests may result in values that are associated with low ovarian reserve. Specifically, low AMH levels, low antral follicular count (AFC), and high FSH levels are all indicators that you have poor ovarian reserve. Any one abnormal test generally shows that fertility potential has decreased.‍

It's important to understand that abnormal ovarian reserve does not mean you will not be able to conceive

It's important to understand that abnormal ovarian reserve does not mean you will not be able to conceive. It is only an indication that fertility potential has declined. Even though these test results do not tell your doctor whether you can get pregnant, they do indicate how you may respond to specific treatment. You probably know that female age is a predictor of fertility outcomes. However, not all women at a given age respond to a specific treatment the same way, and age is not the only predictor. There are many young women with normal ovarian reserve testing results who have difficulty conceiving.

Consider a hypothetical 37-year-old patient. Her doctor has told her that her AMH is low. That means the patient’s AMH is probably lower than what is common among other 37-year-old patients. Her doctor then recommends IVF treatment.  The results of her AMH will indicate the most effective dosage of medication to be administered, as well as the likelihood of successful IVF. While no single ovarian reserve test can predict the potentiality for pregnancy, it can be a valuable tool in in developing an individualized treatment plan, helping facilitate a pregnancy for you.

Please find further information on this topic on ASRM website.