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fertility

Can You Get Pregnant with One Ovary? What to Expect

Many women conceive naturally with one ovary. The remaining ovary typically compensates, producing eggs and hormones for both sides. Fertility may be somewhat reduced — particularly if ovarian reserve was already limited before surgery — but natural conception and IVF success are both possible, with ovarian reserve testing being the best predictor.

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How does the remaining ovary compensate?

The ovaries do not divide the workload equally — each month, whichever ovary has the dominant follicle takes responsibility for that cycle. After one ovary is removed, the remaining ovary continues to develop follicles and ovulate on a regular cycle.

Research in women who have had one ovary removed shows that the remaining ovary often increases its follicle recruitment — compensating at least partially for the loss. Menstrual cycles typically continue without disruption, and ovulation occurs from the single ovary each month. 1

The key factor is how much functional reserve remains in the surviving ovary. If the removed ovary was normal and the remaining one is healthy, compensation is generally good. If reserve was already reduced, or if the remaining ovary has also been affected by surgery, disease, or endometriosis, reserve may be more limited. 2

Does one ovary affect chances of natural conception?

For most women with a healthy remaining ovary, natural conception is possible, and many become pregnant without fertility treatment.

However, some considerations apply: - Ovarian reserve (as measured by AMH) may be somewhat lower on average in women with one ovary compared to those with two — reflecting the reduced follicle pool and potential surgical impact. 2 - Menopause may occur somewhat earlier on average in women who had an ovary removed, particularly if the remaining ovary was also affected during surgery. - If only one tube is open (for example, if the tube on the same side as the removed ovary was also removed or damaged), this reduces the effective conception pathway per cycle.

None of these findings mean conception is unlikely — they mean it is worth being thoughtful and not delaying unnecessarily if you are trying to conceive. 1

What if I had the ovary removed because of endometriosis or a complex cyst?

The underlying reason for the surgery matters:

Endometrioma (ovarian cyst from endometriosis): endometriosis can affect the remaining ovary and surrounding structures. Even before any surgery, women with endometriosis may have reduced ovarian reserve. Surgery itself on an endometrioma can further reduce reserve in the operated ovary. If you have a history of endometriosis affecting both ovaries or multiple surgeries, reserve testing is especially important. 3

Benign functional cyst or dermoid cyst: if the removed ovary was otherwise healthy and the surgery was straightforward, the remaining ovary is generally healthy and compensation tends to be good.

Ovarian torsion: if the ovary was removed due to twisting and loss of blood supply, recovery of the surviving ovary is generally good if it was not itself compromised.

What should I do before trying to conceive?

A reasonable approach:

1. Know your ovarian reserve: request AMH and AFC testing from your gynecologist or a reproductive endocrinologist. These give the most accurate picture of what fertility treatment (or natural conception) might look like. 2

2. Do not wait longer than necessary: given that reserve may be reduced, the standard recommendation to wait a year before seeking evaluation may not apply in the same way. Many specialists suggest evaluating after six months of trying at any age, or earlier if you have additional concerns. 1

3. Consider earlier consultation: a visit to a reproductive endocrinologist — not necessarily to start treatment, but to understand your situation — is often worthwhile before you even start trying.

Can IVF work with one ovary?

Yes. IVF does not require two ovaries. The stimulation medications act on whatever follicles are present, and the remaining ovary can respond and produce eggs. The number of eggs retrieved per cycle may be lower than average, which can affect how many attempts are needed, but many women with one ovary have had successful IVF cycles. 1

Your fertility specialist will use your AMH, AFC, and response to stimulation to guide the protocol and set realistic expectations for each cycle.

Common questions

Will I go through menopause earlier with one ovary?

Some research suggests the average age of menopause may be modestly earlier in women with one ovary — by a few years on average — though this varies considerably and is not guaranteed. If you have concerns about hormonal changes, this is worth discussing with your gynecologist.

My right ovary was removed — does it matter which side?

Side generally does not matter. Both ovaries are functionally equivalent. The remaining ovary — whichever side it is — will continue to function normally.

Can I still use my one ovary for egg freezing?

Yes. Egg freezing stimulates whatever follicles are present. If your AMH and AFC are in an acceptable range, egg freezing is possible with one ovary. A consultation with a reproductive endocrinologist to assess reserve first is sensible.

Where should I go for fertility evaluation after ovary removal?

A board-certified reproductive endocrinologist is the specialist for this. Your gynecologist can also order initial ovarian reserve testing (AMH, AFC). Gale can help you prepare for those appointments.

Talk to a clinician

Gale can match you with a licensed clinician for a visit.

Find care →

When to seek evaluation sooner

  • —Hot flashes, irregular periods, or other signs of early menopause — may indicate the remaining ovary is under-functioning
  • —No periods after surgery — worth evaluating promptly
  • —Prior endometriosis affecting the remaining ovary — reserve may be more limited than expected

This article provides general health education only. Fertility after ovary removal varies widely by individual. Ovarian reserve testing and a consultation with a reproductive endocrinologist or gynecologist will give you a clearer personal picture.

References

  1. 1.Practice Committee of the American Society for Reproductive Medicine (2021). Fertility evaluation of infertile women: a committee opinion. Fertility and Sterility. doi:10.1016/j.fertnstert.2021.08.038 ✓Role of ovarian reserve assessment (AMH and AFC) in evaluating fertility, including in women with surgically reduced ovarian complement; recommendation for earlier evaluation when reserve may be reduced
  2. 2.Practice Committee of the American Society for Reproductive Medicine (2020). Testing and interpreting measures of ovarian reserve: a committee opinion. Fertility and Sterility. doi:10.1016/j.fertnstert.2020.09.134 ✓AMH as the most sensitive marker of ovarian reserve; interpretation in context of prior surgery and potential impact on reserve
  3. 3.ESHRE Endometriosis Guideline Development Group (2022). ESHRE guideline: endometriosis. Human Reproduction Open. doi:10.1093/hropen/hoac009 ✓Endometriosis and its effect on ovarian reserve; surgical management of endometriomas and the risk of reduced reserve in the operated ovary

3 sources, numbered by first appearance. General health information, not medical advice — synthetic demonstration content.