Figure 3.

A working model for extended fertility. Female fertility at an advanced age is determined by a combination of factors: the quality of the oocytes (represented by telomere length), the oocyte quantity (represented by AMH levels or Antral Follicle Count), and male and physiological–behavioral characteristics (represented by sperm count, proper timing of intercourse, demonstration of normal female anatomy, etc.). While low AMH levels are permissive to extended fertility, oocyte quality and physiological and behavioral factors may be limiting and compensating for each other.