Ovarian reserve is a widely used concept in assisted reproduction but patients do not always know the meaning of the results and their clinical implications. A woman’s ovarian reserve refers to the total number of eggs in their ovaries and provides information regarding their reproductive future and their replication potential.

The ovarian reserve is inversely proportional to the age of the woman, so that the older the woman, the lower ovarian reserve and egg quality.

Until relatively recently, we used an ultrasound scan and an analytical blood analysis test as evidence of a woman’s ovarian reserve (which determined the values of FSH, LH and estradiol) performed both between the 3rd and 5th day of the menstrual cycle.

Currently there exists a new AMH application which acts as a marker of ovarian reserve and predicts the response of a woman’s ovaries to ovarian stimulation in assisted reproduction treatment.

Taking into account the experience with our patients, at IB we consider diminished ovarian reserve at a value of below 5pmol/l. These values should be considered alongside ultrasound imaging. 

Faced with a low ovarian reserve, what options do we have if we have not yet considered the option of motherhood? There are three options:

  • Firstly, we may consider bringing our plans of motherhood forward; seeking pregnancy as soon as possible if you have a stable partner.
  • If this is not the case and you do not want to consider this first option of motherhood as yet, there is the option of assisted reproduction treatment where we can obtain and freeze embryos using the vitrification methods. In that way you can wait the moment that you consider appropriate to transfer the embryos and become pregnant.
  • If you do not have a partner and would like to postpone maternity, it would be possible to perform one or more fertility treatments to attain your eggs and then freeze them (egg vitrification) waiting for the right time for fertilisation (with conjugal sperm or donor sperm i f the patient is looking to be a single parent ). Subsequently the embryos are transferred to achieve pregnancy.

Dr Ana Fabregat, Pharmacist at Instituto Bernabeu.



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