My patients will often hear me say, “it just takes one good one”! Or that fertility is a functional diagnosis. What the latter means is that: until you try, you don’t know if you will have trouble with your fertility.

Low ovarian reserve does not equal infertility. If your numbers are low but you get pregnant, you do not have infertility and likewise, if your numbers are high but you do not get pregnant, that you have infertility.

The caveat to that is that for women, unlike men, our ovarian reserve, egg quality and fertility do decline with age. We are born with our eggs and we do not make more eggs during our lifetime. During ovarian stimulation for IVF or egg freezing, we do not make eggs. We simply “ rescue” eggs that were due to die that month and make better use of them.

Better numbers may equal better chances. However, it does just take one good one.

We recently reviewed over 250 cases of “ low egg reserve” where the number of available eggs was 5 or fewer. We stratified the data into egg age.

Success rates of fresh embryo transfer in cases with 1 to 5 eggs collected. N = 273 Embryo Transfers (ET)

<35	35-37	38-40	41-42
Biochemical pregnancy (%)/ET	56.3%	47.8%	47.8%	24.0%
Clinical pregnancy (%)/ET	48.4%	43.5%	42.2%	18.0%

5 percent of cases with fewer than 5 follicles did not have have eggs available at harvest. That means that 95 percent did. While the pregnancy rates are lower than if there were more than 5 eggs, the pregnancy rates are still very encouraging.