TITLE:
Very Low AMH: Spontaneous Conception after Successful IVF/ICSI Pregnancy in a 37-Year-Old Woman—About a Case and Literature Review
AUTHORS:
Zenabou Boussini, Jean de Dieu Sanou, Waaviel Carine Linda Some, Semon Paulin Kam, Jean De La Croix Millogo, Alihonou Serges Eric Togbé, Evelyne Komboigo, Der Adolphe Somé
KEYWORDS:
Anti-Müllerian Hormone, Diminished Ovarian Reserve, IVF/ICSI, Spontaneous Conception, Ultra-Short Antagonist Protocol
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.16 No.6,
June
29,
2026
ABSTRACT: Background: Anti-Müllerian hormone (AMH) is the reference biomarker of ovarian reserve. Extremely low levels are classically regarded as a marker of impending menopause and a predictive factor for failure of assisted reproductive technology (ART) and spontaneous conception. Case presentation: We report the case of a 37-year-old nulliparous woman presenting with 15 years of primary infertility and severely diminished ovarian reserve (AMH 0.14 ng/mL, FSH 11.1 IU/L, AFC = 8). Following refusal of donor-oocyte IVF initially recommended, an ultra-short antagonist protocol (ganirelix from cycle day 1) yielded 12 oocytes and 4 grade-A blastocysts. Single embryo transfer resulted in a live birth in July 2023. Twenty-two months post-caesarean, while still breastfeeding, the patient achieved an unassisted spontaneous pregnancy, delivering on 25 February 2026. Conclusion: This case challenges the absolute prognostic value of AMH in women under 40 and highlights a potential post-pregnancy “priming” effect on residual ovarian function. Clinicians should avoid using AMH as the sole criterion to deny ART or predict future natural fertility.