Ovarian reserve is the pool of eggs present in the ovaries at any given time. Low ovarian reserve is when there is a physiological decrease in the number of eggs, resulting in an insufficient number to ensure a reasonable chance of pregnancy. Generally, it is caused by aging ovaries. Patients can have diminished ovarian reserve but intact ovarian function.
Also ovarian tissue can be destroyed through torsion, surgical removal of part or all of the ovary, ovarian cysts caused by endometriosis, benign or malignant ovarian tumors, radiation or chemotherapy, immunological conditions, pelvic adhesions, or a high body mass index.
We may perform an evaluation cycle to determine the AMH (anti-mullerian hormone) and AFC (antral follicle count) levels to see if it even makes sense to stimulate the ovaries. The AMH level indicates the number of eggs in the ovaries; the higher the number the greater the number of eggs. If the ovarian reserve is very low, you won't get more than one to two follicles. Then the doctor might suggest a natural cycle or a low dose IVF cycle .