The term low ovarian reserve may sound alarming when you want to become a mother, but it does not mean that a woman is infertile. If you are under 35 and ovulate regularly, your chance of getting pregnant is similar to that of someone with a “normal” egg reserve. Nowadays, with current fertility methods, there is a chance of pregnancy even with as few as 3 high-quality follicles.
In this article, we would like to explain the relationship between ovarian reserve, follicles, ovulation and pregnancy, by offering you data, tips and techniques that can help you to increase the chances of pregnancy.
What is ovarian reserve and how is it related to follicles?
Ovarian reserve is the number of eggs a woman has at any given time. There are several tests to measure it, one of the most common being the antral follicle count (AFC) by transvaginal ultrasound.
The ovulation process has several phases, one of which is the ovarian stimulation phase, which allows the development of an ovarian follicle. In this process, it is understood that the more follicles you have in your ovaries, the more chances you stand of getting pregnant.
The follicle is an anatomical-functional structure that is part of the ovary. If the oocyte (egg) is produced by the ovary and matures throughout the ovulation cycle, the number of ovarian follicles is an indication of how many of these structures would be activated periodically during ovulation. In other words, the number of antral follicles in the ovaries determines the ovarian reserve.
How many follicles is it normal to have in each ovary and how does it affect pregnancy?
The follicle count per ovary is one of the most common methods used to determine ovarian reserve and is expressed as the number of follicles per ovary observed (the aforementioned antral follicles) in a vaginal ultrasound scan during the first days of the cycle. A woman’s ovarian reserve depends on the number of antral follicles, thus:
- High ovarian reserve: more than 12 follicles.
- Normal ovarian reserve: 6 to 10 follicles.
- Low ovarian reserve: if the count is below 6.
If we stimulate follicular development in a cycle, we can obtain a greater number of mature eggs and increase the likelihood of pregnancy. Or, in short, if I have follicles in my ovaries, I can get pregnant. To what degree, or how likely, depends on the existing count.
Can the likelihood of pregnancy be predicted by the follicles in each ovary?
If a woman is undergoing fertility treatment, it is possible that, at the time of puncturing the antral follicles, no oocytes are retrieved or that some oocytes are immature and therefore unsuitable for fertilisation. Therefore, the number of mature oocytes recovered after ovarian puncture may be lower than the number previously estimated by ultrasound.
But, for example, if only 3 follicles have been stimulated and 3 mature oocytes are obtained from them, you have a chance of continuing with the fertility treatment and getting pregnant. In short, the greater the number of follicles stimulated that contain mature oocytes at the time of the puncture, the greater the chance of pregnancy.
To find out what the percentages are of you getting pregnant with a low ovarian reserve, we recommend you make an appointment with one of our specialists. Artificial insemination treatment is not the same as In vitro fertilisation treatment. At Eugin we adapt to your needs in order to offer you the best possible option.
What is the normal ovarian reserve at the age of 40?
Every woman is born with a certain number of eggs and, over the years, this reserve is depleted. This is part of the natural ageing process. Every woman, at some point, will have a low ovarian reserve that will lead to menopause and the inability to become pregnant with her own eggs.
Having a low ovarian reserve after the age of 40 is not uncommon. According to statistics, a woman is born with approximately 2 million eggs. At puberty, the number of eggs is between 300 000 and 500 000. At the age of 37, the number of eggs decreases to approximately 25 000, although some women experience this decrease earlier. By the age of 51, the number of eggs in a woman’s ovaries drops to 1000.
However, having fewer eggs does not mean that it is impossible to get pregnant with your own eggs. The most important thing is the quality of your eggs. If you have fewer but good quality eggs, it is likely that you will obtain at least one embryo capable of being implanted in the uterus and resulting in a pregnancy. It is true that there is a direct relationship between infertility and a low ovarian reserve (because when there are fewer eggs the quality tends to decrease), but this is not always the case and for this reason it is advisable to see a fertility specialist.
Is it possible to become a mother with low ovarian reserve?
As we have already mentioned, pregnancy is possible with low ovarian reserve. Moreover, thanks to technical advances, there are methods that can help to increase the chances. For example, in most fertility treatments, hormonal stimulation is used to increase the effect of natural ovarian stimulation. In this way, we try to encourage the development of more than one ovarian follicle per month. Women with low ovarian reserve currently have several options to achieve their wish to become mothers.
In the case of women over 35, with the advances in fertility treatments, we can do more than one IVF cycle so as to increase the chances in your favour. In addition, if you have a low ovarian reserve and want to postpone childbearing, there is the possibility of freezing your eggs. Since we know that both egg quality and reserve will only diminish over time, it makes sense to capitalise on that earlier and store as many good quality eggs as you think you will need for your family planning goals.
In conclusion, it is important to remember that low ovarian reserve does not mean infertility. If you are under 35 and ovulate regularly, your chances of getting pregnant increase significantly. It is also important to remember that there are treatments available for women with low ovarian reserve and other fertility problems. Talking to a fertility doctor about what options might be best for you is key. At Eugin, we will support you through the entire process.
