When is IVF recommended for diminished ovarian reserve?

Diminished ovarian reserve means testing suggests fewer remaining eggs than expected for the person’s age. Tests such as anti-Müllerian hormone, follicle count and other hormone measurements can inform the discussion, but they do not by themselves predict whether pregnancy will occur.

IVF may allow eggs to be collected in a coordinated cycle and fertilised outside the body. A lower reserve can mean fewer eggs are available to collect, so the clinician may discuss starting promptly, adjusting medication, considering more than one retrieval, or other family-building options. Age, egg quality, sperm and the uterus remain relevant.

Take all ovarian reserve results together rather than focusing on a single value. Ask whether testing should be repeated and whether the result reflects response to stimulation or only egg quantity. Review ovulation, semen, the uterine cavity and any medical conditions before choosing a route.

Ask how medication will be tailored, what happens if few eggs develop, and whether embryos may be tested or stored. The plan should include a clear review point so decisions can change as new information appears.

Arrange fertility advice promptly after being told that ovarian reserve is diminished, particularly if pregnancy is a current goal or periods have become irregular. Seek urgent care for severe abdominal swelling, breathing difficulty or intense pain during fertility medication, as these symptoms need immediate assessment.

Which tests support this finding? What response might you expect from stimulation? Should we start now or consider another option? How will you adjust the protocol? What is the plan if few eggs or embryos result?