For many female athletes, peak physical performance often comes with sacrifices—but fertility shouldn’t have to be one of them. Recent research suggests that some female athletes experience a reduced egg reserve, a condition that could impact future fertility.
What Is Ovarian Reserve?
Ovarian reserve refers to the number and quality of eggs a woman has. A lower reserve may mean fewer opportunities to conceive, and eggs may also be of lower quality, potentially increasing the risk of miscarriage or lowering the success rate of pregnancy.
Why Might Athletes Be Affected?
Although the exact reasons aren’t fully understood, studies suggest that intense, high-endurance training—especially at elite levels—can lead to disruptions in reproductive health. This includes:
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Amenorrhea (absence of menstrual cycles)
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Disruption of the hypothalamic-pituitary-ovarian (HPO) axis, which regulates reproductive hormones
These changes can silently reduce egg reserve over time.
Early Detection Matters
The good news? Early detection can open doors to effective treatments and proactive fertility planning. Female athletes who plan on having children—or are considering egg donation—may benefit from testing and possibly preserving their eggs at a younger age.
A Tool for Awareness: The AMH Test
A simple blood test called the Anti-Müllerian Hormone (AMH) test can help estimate ovarian reserve. Here’s a general guide for interpreting AMH levels:
| AMH Level (ng/ml) | Ovarian Reserve |
|---|---|
| Less than 0.6 | Low |
| 0.7 – 2.9 | Normal |
| Greater than 3 | High |
What Are Your Options?
If you’re found to have a low reserve, there are several paths forward:
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Lifestyle Adjustments: Reducing training intensity or improving nutritional support
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Medications: Hormonal therapies may help improve ovarian function
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Assisted Reproductive Technologies: Options like IVF or oocyte cryopreservation (egg freezing) can offer fertility security
Bottom Line: If you’re a female athlete, especially one training at high levels, understanding your fertility early could be one of the most important steps you take for your future. Speak to a reproductive specialist to explore testing and proactive options tailored to your lifestyle.
It is worth noting that there are conflicting studies on this topic, one suggesting the high intensity athletics is not a cause of low ovarian reserve, J. Ovarian Res., 2022 Sept. 15; 16 107.
Another more recent prospective study, Journal of Ovarian Research, 2022 Sep 16;15:107, found that athletic, normo-ovulatory women have ovarian reserves that are at least as good as those of the general population. As this is the first prospective study examining this issue, it should provide some optimism to women engaged in high physical activity regarding ovarian reserve. Nevertheless there are conflicting findings in this area of research.