What are the chances of pregnancy if ovarian reserve is low?

The ovarian reserve is a critical factor in assessing a woman's fertility potential, typically measured by levels of anti-müllerian hormone (AMH), follicle-stimulating hormone (FSH), and inhibin B. A low ovarian reserve is often perceived as a barrier to conception. However, recent research suggests that the relationship between ovarian reserve and fertility may not be as straightforward as previously thought.

Study Insights from "JAMA"

A notable study published in the "Journal of the American Medical Association" (JAMA) challenges the conventional wisdom regarding low ovarian reserve and fertility. This prospective cohort study, titled "Time to Conceive," examined the impact of ovarian reserve biomarkers on the likelihood of conception.

Study Design and Participants

The study included 750 women aged 30 to 44, who had no history of infertility-related conditions such as polycystic ovary syndrome (PCOS), endometriosis, or recent contraceptive use. These women had been trying to conceive for three months or less and were in relationships with male partners without known fertility issues.

Key Findings

Conception Rates at 6 Months:

• Women with low AMH levels (<0.7 ng/mL) had a conception rate of 65% at six months.
• Women with normal AMH levels had a conception rate of 62% at six months.
• Women with high serum FSH levels (>10 mIU/mL) had a conception rate of 63% at six months.
• Women with normal FSH levels had a conception rate of 62% at six months.

Conception Rates at 12 Months:

• At 12 months, women with low AMH levels had a conception rate of 84%.
• Women with high AMH levels had a conception rate of 75%.
• Women with high FSH levels had a conception rate of 82%.
• Women with normal FSH levels had a conception rate of 75%.

The study adjusted for various factors, including age, BMI, ethnicity, smoking status, and recent use of hormonal contraception. It found no significant difference in conception rates based on the levels of these biomarkers, indicating that low ovarian reserve did not significantly affect the probability of conception within the study period.

Implications of the Study

These findings suggest that women with low ovarian reserve may still have comparable chances of conceiving as those with normal ovarian reserve. The study's results are particularly reassuring for women in the older age group (38-44 years), who often face heightened concerns about fertility.

Practical Considerations

While these findings are promising, it's important to consider the broader context of fertility:

• Individual Variability: Each woman's fertility journey is unique. Factors such as overall health, lifestyle, and reproductive history play significant roles.
• Comprehensive Evaluation: Women with low ovarian reserve should undergo a comprehensive fertility evaluation to identify any other potential barriers to conception.
• Assisted Reproductive Technologies (ART): For those facing difficulties, ART options like in vitro fertilization (IVF) remain viable pathways. Clinics such as NatuVitro Fertility Clinic in Barcelona, known for their expertise and high success rates, offer advanced treatments tailored to individual needs.

Contrary to traditional beliefs, a low ovarian reserve does not necessarily equate to reduced fertility. The study published in JAMA provides evidence that women with low AMH or high FSH levels can still have substantial chances of conceiving within six to twelve months. While ovarian reserve remains a crucial aspect of fertility, it is not the sole determinant. Women should consult with their gynecologists to understand their individual fertility profiles and explore the most appropriate options for their reproductive goals.