In 2024, we treated 75 patients with AMH below 5 pmol/L. Their average age was 37.1 years, ranging from 29 to 44 years.

64 patients underwent an IVF/ICSI procedure. Two patients did not reach aspiration, and no transfer was performed in 13 patients (absence of follicular development, no egg was obtained, poor egg quality, absence of or improper fertilisation, inadequate embryo development).

Of the 49 patients who underwent embryo transfer, 13 had a positive pregnancy test, but 4 pregnancies were biochemical. Of the remaining 9 pregnancies, one resulted in a miscarriage, so in this group of patients with a low reserve we have a success rate of 12.5% per cycle and 16.3% per transfer.

Patients with successful pregnancies were 33, 33, 36, 36, 37, 38, 38 and 40 years old. Their AMH was 2.7, 4.9, 3.3, 3.3, 2, 3, 3.6 and 4.8, respectively.

11 of the above 75 patients underwent FET, five of whom became pregnant. Only one of these pregnancies continued to develop.

This sample is too small for definitive conclusions, but we wanted to highlight these findings to ensure that patients with a low reserve can have realistic expectations and be aware that there is an almost 25% chance that they will not undergo an embryo transfer, that cryopreservation of low reserve embryos is unlikely to help achieve success, and that in this case there is a high chance of miscarriage and biochemical pregnancies. If they get to the embryo transfer in a fresh cycle, the chance of pregnancy, although small, exists, and the pregnancy is likely to be normal.

However, our last year’s sample of 75 women, 40 of whom had an AMH lower than 3 pmol/L (two normal pregnancies) and 17 had an AMH lower than 2 pmol/L (none resulted in either normal or irregular pregnancies), illustrates the current limitations of success of modern medicine. As laboratory work improves, this success rate increases day by day, so we hope that these patients will get help one day, but for now, we must advise them to consider alternative paths to parenthood that do not rely on their own reproductive cells.