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Question - TTC with Half an Ovary & Premenopause

"I am 39, and my doctor says I am starting to go into premenopause (based on a blood test). I am also functioning with half of a ovary. Is it at all possible to have a child?"

Response - When people have trouble conceiving and delve into the intricacies of human reproduction, they are always amazed that anyone conceives at all. Seems like every little thing can become a glitch in the system and make getting pregnancy nearly impossible.

In this case, you're dealing with several issues: your age, your ovarian situation, and your blood test results which led your doctor to state you may be headed toward menopause. Let's consider each of those in regards to your question about the possibility of having a child:

Age: It is a fact that women have a definite biological window of opportunity for reproduction to occur. In general, a woman who is in her late 30's is less fertile than a woman who is in her early 30's or younger. Again, we're speaking in generalities here, and it is also the case that some women are more fertile than others and for longer periods of the lifespan. The norm, however, is that women are most fertile in their late teens to mid-20's.

Ovary: First, if you meant that you have only one (as opposed to two) ovary, then chances are good that your fertility is not highly affected by that fact. Generally, one ovary will 'pick up where the other left off,' so to speak, and produce the same amount of ovulation as two would have. As an aside, it may be of help for you to know that it's believed most women do not ovulate every cycle throughout their lifespan, and this includes women with normal fertility.

Second, if you meant literally that you have only half the tissue of one ovary, and no full ovaries, then your fertility may be reduced. Again, however, it is difficult to speak in anything other than generalities here. It is possible for ovarian tissue to promote ovulation under less than optimal circumstances. While your fertility may be diminished, it is not necessarily totally void.

Blood test: Chances are that your doctor is referring to a Day 3 FSH test. This would have been drawn on the third day of your cycle. It tests your ovary's response to follicle stimulating hormone (FSH). Too much FSH indicates poor response, which is usually linked to poor outcomes regarding conception with fertility treatment.

When women's bodies head towards menopause, their ovaries begin secreting less estrogen, which results in the pituitary gland secreting more FSH, hence, the higher FSH level. The normal age of menopause is between 40 and 55 years; generally, menopause prior to that is considered "premature."

Most doctors will use a combination of your age and FSH as indicators of whether or not you're a good candidate for IVF or other assisted reproduction techniques (ART). Studies have concluded that age and FSH level can be used quite reliably for the purpose of predicting pregnancy outcomes.

All that said, your question is whether it's "at all possible to have a child?"

I recommend you step back, as much as possible, and review your situation and your true desires. The answer, of course, to your question is "Yes, it is possible." Is it probable? There are absolutely no guarantees -- and anyone who offers you one is trying to fool you.

Even if you are unable to conceive in either a traditional manner or with ART, there exist alternatives -- such as using donor eggs, surrogates, or adoption. The question is whether or not having a child through these means is an option for you. That's a question that only you can resolve.

For more information on this topic:

Age as a Cause of Infertility
How to Make a Family's Fertility Center

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