Many women think that two ovaries are essential to be able to get pregnant, but nothing is further from the truth, with only one ovary it is possible. It is true that having only one ovary ovulates less frequently and getting pregnant may seem more difficult and cost twice as much as if the woman has both active ovaries, but it is not more complicated at all.

The chances of pregnancy with only one ovary

  • What really matters in order to get pregnant is that the fallopian tube is in perfect condition, and this small tube that connects the ovary to the uterine cavity is essential. If the fallopian tube is not right it is unlikely that a woman can get pregnant naturally. For a woman to become pregnant, three important factors are necessary: ​​that the spermatozoa are healthy and that they are deposited in the female reproductive tract, that the egg cell is also healthy and that the fallopian tube -which connects the uterus with the ovary- allows the sperm to go up to the ovary to be able to fertilize it and that in this way it can travel the path that leads to the uterus and be able to carry out the implantation.
  • If you only have one ovary and you want to get pregnant, you should not think that you have less chances than another woman, far from it! You will only have to calculate when your fertile days are, you can use your body signals -more flow, higher body temperature, etc. The calculators that you can find on Internet pages or even in mobile phone applications. Once you know when your fertile days are, you will only have to have intercourse on the indicated days – without protection – to have a better chance of getting pregnant.
  • Most women with only one ovary ovulate normally and have no trouble conceiving. Also, if this is your case and you want to conceive a child, you can go to your doctor to explain all your concerns about it.
## How having one ovary affects fertility — the physiology explained When one ovary is absent or non-functional (due to surgery, torsion with subsequent removal, congenital absence, or damage from cystectomy/chemotherapy), several physiological responses occur that are important to understand when planning pregnancy. - **Compensatory function:** The remaining ovary often increases activity — a process called compensatory hypertrophy. This means the single ovary can produce enough eggs and hormones to sustain normal ovulation in most women. - **Ovarian reserve vs. ovulatory pattern:** Even if the total number of eggs (ovarian reserve) is reduced when you have one ovary, the pattern of regular ovulation can continue. Ovarian reserve tests such as anti-Müllerian hormone (AMH) and antral follicle count (AFC) may be lower, but a lower reserve does not automatically equal inability to conceive. - **Role of the fallopian tube:** The health of the ipsilateral and contralateral fallopian tubes is critical. Sperm may still reach and fertilize an egg from the remaining ovary because the fimbriae can capture an egg even if it is released from the opposite side in some cases, although fertilization is most efficient when tube and ovary are on the same side. - **Age still matters:** The single most important determinant of natural fertility is age. A woman with one ovary at age 28 has a far better chance of conceiving naturally than a woman with two ovaries at age 40. Clinical takeaway: having one ovary is not a barrier in itself — but assessing ovarian reserve, tubal patency, partner fertility, and age gives the full picture. ## Practical, step-by-step plan to maximize your chances of conceiving with one ovary Below is an actionable, evidence-based plan you can follow over the first 3–6 months of trying to conceive naturally. Use this as a roadmap and adapt it with your gynecologist. 1. Preconception checkup (months -2 to 0) - Get baseline tests: - AMH and Day 3 FSH (to estimate ovarian reserve). - TSH and prolactin (endocrine causes of anovulation). - Rubella immunity and other routine preconception labs. - STI screening (chlamydia, gonorrhea) if indicated. - Urine culture if recurrent UTIs. - Partner semen analysis (basic: volume, concentration, motility, morphology). - If you have pelvic surgery history or infections, request a tubal patency test (HSG) or laparoscopy if indicated. 2. Start folic acid and optimize health (month 0 onward) - **Folic acid 400–800 mcg** daily at least 1 month before conception and through the first trimester. - Check and correct vitamin D deficiency, iron if anemic. - Aim for BMI 18.5–25 for best fertility outcomes. If BMI is >30 or 1.5–2.0 ng/mL** usually indicates adequate reserve for natural conception and for standard IVF stimulation in younger women. - **AMH 0.5–1.5 ng/mL** indicates reduced reserve but pregnancy is still possible; counsel about time-sensitive decision-making. - **AMH 36 and AMH low: discuss expedited fertility strategies (IVF) or egg donation. - For all: consider lifestyle optimization and treat reversible endocrine problems (thyroid, hyperprolactinemia). - Communication template for patients - "Your AMH suggests reduced egg quantity, not necessarily egg quality. Given your age, I recommend an expedited referral to a fertility specialist and, depending on your family building timeline, we can discuss starting with IUI or going directly to IVF." ### Surgical history and planning future pregnancies (when one ovary was removed or damaged) - If your ovary was removed due to cysts or endometriosis: - Ask for a detailed operative report. Important details: was the fallopian tube preserved, any adhesions, and how much ovarian tissue remained? - If endometriosis is present, treating it surgically can improve pelvic anatomy but sometimes reduces ovarian reserve; fertility planning should be proactive after surgery. - If ovary was removed for torsion or ischemia: - Understand that the remaining ovary often recovers function. Monitor cycles and ovarian reserve. - Practical pre-surgery counseling for patients who still wish to conceive: - If an ovarian cyst or endometrioma requires removal, discuss fertility-sparing surgery with the surgeon. - **Ask about cystectomy vs partial oophorectomy** and the likelihood of preserving healthy ovarian tissue. - Consider egg freezing prior to surgery if the cystectomy is likely to significantly reduce reserve and you plan to delay pregnancy. - Postoperative follow-up plan: - Re-check AMH 6–12 weeks after surgery (values can change). Perform an AFC if cycles are regular. - If low reserve is detected, discuss timing to attempt conception and fertility options. ## Practical advice for timing intercourse, tracking ovulation, and daily habits that matter - Timing intercourse - Sperm survive ~3–5 days in the female reproductive tract; the egg survives 12–24 hours after ovulation. - Aim for intercourse every 24–48 hours starting 3 days before expected ovulation through the day of ovulation. This maximizes chances without unnecessary stress. - Tracking ovulation — tools and how to use them - **Urinary LH kits**: start testing around cycle day 10–12 for average cycles. A positive test means ovulation is likely in 24–48 hours. - **Basal body temperature (BBT)**: confirms ovulation retrospectively; useful for cycle pattern recognition. - **Cervical mucus monitoring**: egg-white, stretchable cervical mucus is a sign of high fertility. - **Transvaginal ultrasound**: used during fertility treatment or when cycles are irregular to pinpoint follicle rupture. - Daily habits that influence fertility - Nutrition: balanced diet, adequate protein, omega-3 fats, and micronutrients. - Weight: achieving BMI in the optimal range improves ovulation and implantation. - Caffeine: moderate intake (<200 mg/day) is acceptable. - Exercise: moderate exercise is beneficial; avoid extreme endurance training if trying to conceive. - Stress management: chronic stress can interfere with cycles — use evidence-based tools like cognitive behavioral therapy, mindfulness, or counseling when needed. - Avoid misinformation: fertility trackers and supplements - Many supplements claim to “boost ovarian reserve” — currently no medication reliably increases the number of eggs. Some supplements (myo-inositol, DHEA) may be used in select IVF protocols, but should be prescribed by a clinician. - Be wary of expensive or unproven “fertility boosters.” Discuss with your doctor before starting any supplement. - Helpful products - Home ovulation kits and BBT thermometers are reasonable purchases — see our curated recommendations in the [shop](/shop). - For more reading on related reproductive topics, visit our [related topic](/blog). ## When to seek specialist care — clear thresholds - Immediate referral to a fertility specialist is recommended if: - You are age 35 or older and have been trying to conceive for 6 months without success. - You have known tubal disease, prior pelvic infection, or prior ectopic pregnancy. - Your partner has a moderate-to-severe abnormal semen analysis. - Your AMH or AFC indicates diminished ovarian reserve, and you want to expedite conception. - Consider earlier referral if: - You will undergo chemotherapy or pelvic surgery that may further reduce ovarian reserve. - You have conditions like severe endometriosis or recurrent pregnancy loss. ## Real-world case studies and what they teach us - Case 1: Natural conception after unilateral oophorectomy - Patient: 29-year-old, left oophorectomy for ovarian torsion at age 25, regular cycles, AMH 2.4 ng/mL. - Action: Tracked ovulation with LH kits and timed intercourse every other day during fertile window. - Outcome: Conceived naturally within 3 months. - Lesson: Young age and preserved ovarian reserve predict good outcomes despite single ovary. - Case 2: Assisted reproduction required after low ovarian reserve - Patient: 38-year-old, right oophorectomy for large endometrioma, AMH 0.4 ng/mL. - Action: Early referral to fertility center; two cycles of mild stimulation IUI unsuccessful. Proceeded to IVF with a tailored high-dose protocol; one euploid embryo obtained and single embryo transfer performed. - Outcome: Pregnancy achieved. - Lesson: Age and ovarian reserve guide the aggressiveness of treatment. IVF can work even with one ovary, but expectations must be realistic. - Case 3: One ovary, tubal disease discovered - Patient: 33-year-old with one ovary and prior pelvic inflammatory disease. HSG showed unilateral tubal blockage on the side of the remaining ovary. - Action: Referred for laparoscopy; tubal surgery unsuccessful in restoring function; moved to IVF. - Outcome: IVF resulted in pregnancy within first cycle. - Lesson: Tubal status is the key factor—if tubes are damaged, IVF bypasses the problem. ## FAQ ### Can I still get pregnant naturally if one ovary was removed years ago? Yes. Many women conceive naturally after unilateral oophorectomy, especially if they are under 35, have regular cycles, and have healthy fallopian tubes and a healthy partner sperm analysis. The remaining ovary often compensates and will ovulate regularly. If you have been trying without success for 6–12 months (depending on age), see a fertility specialist for evaluation. ### Does having one ovary lower my ovarian reserve by half? Not necessarily half in function. Removing one ovary reduces the total number of eggs, but the remaining ovary often increases its activity. AMH and antral follicle count may be lower, but how that translates to fertility depends on age and individual variation. AMH gives a rough estimate of reserve; discuss your results with your clinician to plan next steps. ### How should I time intercourse if I have only one ovary? Use ovulation predictor kits to detect the LH surge and aim for intercourse every 24–48 hours starting 2–3 days before the expected ovulation and continuing through the day of ovulation. Frequent intercourse during the fertile window maximizes the chance without needing to “save up” sperm. ### If my AMH is low, do I need IVF immediately? Not always. Low AMH signals fewer eggs available for stimulation but doesn't predict whether you can conceive naturally this month. Age is a major factor. For women over 35 or with very low AMH, an expedited fertility evaluation and discussion of IVF or egg freezing is reasonable. For younger women with low AMH, timed intercourse or a limited number of IUI cycles may be attempted before IVF, based on shared decision-making. ### Are there lifestyle changes I can make to improve my pregnancy chances with one ovary? Yes. Key actions include starting folic acid, achieving a healthy BMI, stopping smoking, limiting alcohol, ensuring adequate sleep and stress management, and optimizing medical problems such as thyroid disease or diabetes. These changes improve both ovulation and implantation chances and should be part of your preconception plan. --- If you want personalized guidance, bring your operative report (if you had surgery), recent AMH/AFC results, and your partner’s semen analysis to your appointment—these documents help create a tailored fertility plan. For related reading see our [related topic](/blog) and for recommended monitors and ovulation kits visit our [shop](/shop). Category: Pregnancy