A diagnosis of low ovarian reserve — diminished AMH, elevated FSH, or a low antral follicle count — is not the end of the road. At IRFC, we specialize in maximizing outcomes for patients with reduced egg supply, including through egg donation when the time is right.
Before any treatment, your physician takes the time to understand your full history and explain what the evidence shows — so the plan fits you, not a one-size-fits-all protocol.
Talk to a coordinatorEvery woman is born with a finite number of eggs. "Ovarian reserve" refers to the quantity and quality of eggs remaining. It naturally declines with age — but some women experience this decline earlier than expected, a condition known as diminished ovarian reserve (DOR).
DOR does not mean pregnancy is impossible — but it does mean that time is particularly important, and that treatment should be thoughtful and individualized. IRFC physicians bring extensive experience managing DOR at every stage of severity.
AMH (Anti-Müllerian Hormone)
The most reliable single marker of ovarian reserve. Produced by small follicles, AMH reflects the size of the remaining egg pool.
AFC (Antral Follicle Count)
Ultrasound count of small follicles visible at the start of a cycle — a direct measure of immediately available eggs.
FSH (Follicle-Stimulating Hormone)
Elevated early-cycle FSH suggests the brain is working harder to recruit eggs — a sign of diminished reserve.
Estradiol (Day 3)
Elevated early-cycle estradiol can mask FSH elevation and is assessed alongside FSH for a complete picture.
Who Is Affected?
IRFC’s Approach
We believe in honest, direct communication about prognosis — combined with creative, individualized treatment strategies that maximize every available egg. Dr. Lin and Dr. Liu are experienced managing DOR at all severity levels.
IRFC customizes stimulation protocols specifically for DOR patients — using higher doses, shorter protocols, or alternative approaches (e.g., flare or antagonist protocols) to maximize the number of eggs retrieved.
For some DOR patients, a gentle approach retrieving fewer but potentially higher-quality eggs may be preferable. Dr. Liu specializes in mild stimulation protocols tailored to individual response.
Freezing eggs or embryos from several cycles before attempting transfer can accumulate a larger pool — improving the overall chance of success for patients with very low reserve.
For patients who produce very few eggs with stimulation, retrieving the single egg the body selects naturally can be a meaningful option.
Combining PGT-A with IVF allows selection of chromosomally normal embryos — reducing the chance of wasted transfers and miscarriage. Particularly valuable when the embryo pool is small.
When a patient's own eggs are no longer viable, donor egg IVF offers excellent success rates. IRFC's comprehensive donor program, in partnership with Fairfax EggBank, provides access to a wide range of screened, tested donors.
A low reserve is not the end of your story.
"When I was 41, Dr. Lin was honest with me. He said I had about a 10% chance. He designed a protocol around that reality — and my baby is now 6 months old."
— IRFC Patient, Age 41, IVF with DOR
With low ovarian reserve, timing matters. Our physicians will give you an honest picture of your situation — and every available option to move forward with confidence.