Imagine your ovaries are a pond. The pond is full of fish, little useless guppies and nice big bass. When you are young you have tons of fish and most of them are bass, say 90%. As we fish (age), the total number of fish depletes as well as the ratio of guppies to bass. By the time you are 45, you have way less fish and most of the fish are guppies.
If the goal every time we do a fertility cycle is to catch a bass (a good egg), then it makes sense that the chances of catching a bass is going to be higher the younger you are and with the most fish you can catch.
What makes conceiving so hard when you have DOR, High FSH, low AMH, or just unexplained poor response to meds, is that each month when you go fishing, you only catch a few fish. If you are 25 and catching 3 fish, there’s a great chance 1, 2 or even all 3 of those fish will be bass, as your pond is still full of them. If you are 40, you may need to catch 15 or 25 fish to find a bass, and it may take you five fishing trips to catch 15 fish.
Low AMH, High FSH, and low AFC are all indicators that you probably won’t catch many fish each fishing trip. Some with great hormone levels still don’t catch many fish, and I have seen women with low AMH catch a good amount of fish (have a good response). Point is, they are just an indicator of response. They don’t tell you what your guppy to bass ratio is, etc.
Some women luck out and catch a bass on their first fishing trip, regardless of only catching one or two fish. Some women may go fishing 10 times, catch 30 fish and still not catch a bass! Sadly, in spite of all the medical advances out there, catching a bass is still largely based on luck.
When you consider all the things that go into a fishing trip – finances, emotional toll, relationship strain – sometimes we just can’t go fishing over and over and over in the hopes of finding a bass. Sometimes it may make more sense for you to move on to other options, like donor eggs, adoption, etc. This is something that only you and your partner can really know.
Bottom line, there is no lab test to tell you if you can get pregnant with your eggs. There is no magic number on a lab report that says you have all guppies. There is no way of knowing when you have a bass that is growing for ovulation. I believe all we can do is try to make our pond the healthiest environment possible; eat clean, take a good supplement regimen, exercise, get rest and hydration and try to manage stress, and hope that we find a bass OR we find our path to peace, whatever that is.