What are the differences compared to low ovarian reserve?

I will illustrate it with an example:

• In a case of a patient with Low Reserve, we start from a maximum of 6 ovules (3 in each ovary) available, if in the end we obtain 3 mature eggs, we could consider it a ¨normal¨ response, despite having few ovules (low reserve ). A few days ago, we were talking about the ¨Low Reserve¨ (few eggs); Today we will talk about ¨Low Response¨, often confused, even in medical literature, with the previous one, but with a different origin and treatment.

The ¨Low Response¨ is that situation in which, having sufficient quantity of ovules available in the ovaries, but these do not respond adequately to the treatment; the end result is what makes this situation similar to the “Low Reserve”: few eggs available.

• We now have a case of a patient with a low response, on ultrasound we see that he has 12 eggs (6 for each ovary), but in the end we only get 3 mature eggs, it would clearly be a low response, despite having enough eggs.

Here are some concepts to continue explaining the topic

• The ovules are found in ovarian structures called follicles, each follicle contains an ovule; Well, these follicles are microscopic, and every month, only a small group of them grows, and they are visible by ultrasound, they are the so-called antral follicles; And only these are the ones that we can stimulate with the famous injections, until they reach a suitable size and maturity for their puncture and egg collection.

• Thus, a woman with a low reserve will have 6 or fewer antral follicles (and eggs) each month, while a woman with a normal or high reserve will have more than those 6 antral follicles each month.

• You understand then, that when we tell a woman that she has X eggs, what we are saying is that she has X eggs per month; Even women with “low reserve” have many more eggs in the ovary, but in a state that, today, we cannot stimulate or recover.

Well, now through a table, devised by a group of researchers and researchers in assisted reproduction (POSEIDON, they called this classification), I will try to illustrate the differences between Low Reserve and Low Response, as you will see, they add, to the follicles antrales (which is what we see with ultrasound), the Anti-mulleriana Hormone (AMH); but its meaning is similar:  more Antral Follicles, more Anti-mulleriana Hormone in the blood test; What about the age; which as I always insist, is the most important factor in fertility.