Learning that you have a low egg reserve can bring up a lot of questions, especially if you are thinking about pregnancy or in vitro fertilization (IVF). The good news is that a low egg reserve does not tell your entire fertility story.
Diminished ovarian reserve (DOR) means you have fewer eggs remaining in your ovaries than expected for your age. It can affect how your ovaries respond to fertility medications and may influence decisions about when and how to pursue fertility treatment. But it does not automatically mean you cannot conceive or have a healthy pregnancy.
There is no fertility treatment that can restore the eggs you have lost. Instead, low egg reserve treatment focuses on making the most of the eggs available and choosing an approach that fits your age, fertility history, medical history, and family-building goals.
At Piedmont Reproductive Endocrinology Group (PREG), your fertility specialist brings these factors together to create a fertility treatment plan that is specific to you.
What Is a Low Ovarian Reserve?
Ovarian reserve refers to the number of eggs remaining in the ovaries. Egg quantity naturally declines with age, but ovarian reserve can vary from person to person. Two people of the same age can have very different test results.
It is also important to separate egg quantity from egg quality. Ovarian reserve tests help estimate the number of eggs available and how your ovaries may respond to stimulation during fertility treatment. They do not directly measure egg quality.
Age remains one of the strongest predictors of egg quality and reproductive potential, which is why ovarian reserve results are best understood alongside your age and other fertility factors.
How Is Ovarian Reserve Tested?
Your fertility specialist may use several tests to evaluate ovarian reserve, including:
- Anti-Müllerian hormone (AMH): A blood test that helps estimate ovarian reserve and how your ovaries may respond to fertility medications. An AMH level below about 1.0 ng/mL may be associated with diminished ovarian reserve, although results should always be interpreted in context.
- Antral follicle count (AFC): A transvaginal ultrasound that counts the small follicles visible in the ovaries. These follicles contain immature eggs and can provide an estimate of how the ovaries may respond to stimulation.
- Follicle-stimulating hormone (FSH) and estradiol: Blood tests typically measured early in the menstrual cycle that provide additional information about ovarian function.
Together, these results give your fertility specialist a clearer picture of your ovarian reserve and expected response to fertility treatment. A low AMH or AFC alone, however, cannot tell you whether you can conceive naturally.
Can You Increase Your Egg Reserve?
At this time, there is no proven fertility treatment, diet, supplement, or medication that can restore the number of eggs remaining in the ovaries. That does not mean there are no options.
Low ovarian reserve treatment focuses on using the available eggs as effectively as possible. Depending on your circumstances, that may include individualized IVF stimulation, egg freezing, embryo banking, or other family-building options. The right approach depends on your age, ovarian response, treatment history, and goals for having a family.
What Low Egg Reserve Strategies Should You Discuss?
There is no single IVF protocol or fertility treatment plan that is right for everyone with diminished ovarian reserve. Your fertility specialist can help you weigh your options based on your test results, previous infertility treatment response, and what you hope to achieve.
1. Individualized IVF Stimulation
During IVF, fertility medications stimulate multiple follicles to grow at the same time. Follicle-stimulating hormone (FSH) plays an important role in supporting follicle development during this process.
When planning IVF for someone with diminished ovarian reserve, your fertility doctor may consider:
- AMH and AFC results
- Your age
- Other hormone levels
- Your previous response to ovarian stimulation
- The number of eggs retrieved in previous cycles
- Your overall fertility history and goals
Some people with diminished ovarian reserve may benefit from different medication doses or stimulation approaches. More medication does not necessarily mean more eggs, because the number of available follicles is limited.
Your fertility treatment plan is tailored to your ovarian response, with ultrasound and bloodwork used to monitor follicle development throughout stimulation.
2. Consider the Timing of Fertility Treatment
Age and ovarian reserve are closely connected, but they provide different pieces of information.
For example, an AMH result at age 30 has a different reproductive context than the same result at age 40. Age is associated with changes in egg quality and the likelihood of a healthy pregnancy, while ovarian reserve testing primarily provides information about egg quantity and response to stimulation.
A low ovarian reserve result does not mean you need to make an immediate decision. It does mean a timely conversation with a fertility specialist can be valuable, particularly if you are considering pregnancy or fertility preservation.
If you are not ready to pursue pregnancy but want to preserve future options, it can also be helpful to discuss egg freezing sooner rather than later. The age at which eggs are frozen is an important factor in their future potential.
3. Explore Embryo Banking
Some people with diminished ovarian reserve retrieve only a small number of eggs during an IVF cycle. In certain situations, your fertility specialist may recommend considering more than one retrieval to create and freeze embryos.
With embryo banking, eggs are retrieved and fertilized with partner or donor sperm. The resulting embryos can then be frozen for potential use in a future embryo transfer.
This approach is not right for everyone. Factors such as age, number of eggs retrieved, fertilization, embryo development, desired family size, sperm factors, previous fertility treatment, and personal preferences all play a role. Your fertility specialist can help you determine whether embryo banking makes sense for your goals.
4. Consider Donor Eggs or Other Family-Building Options
For some people, continuing IVF with their own eggs is the right choice. For others, donor eggs, donor embryos, or another family-building option may offer a better fit.
We offer donor egg fertility treatment for patients who may have diminished ovarian reserve, age-related fertility changes, concerns about egg quality, or previous unsuccessful IVF treatment. Through our partnership with Fairfax EggBank, patients have access to a large and diverse pool of egg donors, giving you more options as you consider donor egg treatment and your family-building goals.
A low egg reserve diagnosis does not automatically mean donor eggs are the next step. Your fertility specialist can talk through the available options and help you understand what each could mean for your family-building goals.
Can Supplements or Lifestyle Changes Improve Low Egg Reserve?
Healthy habits can support your overall reproductive and preconception health, but they cannot replenish ovarian reserve.
If you are preparing for pregnancy, helpful habits include:
- Avoiding smoking
- Maintaining a healthy weight
- Eating a balanced diet
- Exercising regularly
- Limiting excessive alcohol consumption
- Taking a prenatal vitamin with folic acid before conception
You may also hear about supplements such as CoQ10 or DHEA in conversations about ovarian reserve and egg quality. CoQ10 plays a role in cellular energy production, including in the mitochondria of eggs, but supplements have not been proven to restore ovarian reserve or increase egg count.
DHEA and other supplements can also have risks or side effects and should be discussed with your fertility doctor before you start taking them.
Stress management can support your overall well-being, too. It should not, however, be presented as a fertility treatment for diminished ovarian reserve.
What If IVF Produces Only a Few Eggs?
A smaller number of eggs retrieved does not tell the whole story of an IVF cycle.
After retrieval, mature eggs are fertilized with partner or donor sperm. The embryology team then monitors the embryos as they develop.
Embryos may be cultured to the blastocyst stage before freezing, genetic testing when appropriate, or embryo transfer. Not every egg will mature or fertilize, and not every fertilized egg will develop into an embryo suitable for transfer.
That is why your fertility specialist looks at the full picture after each IVF cycle, including:
- Your ovarian response
- The number of mature eggs
- Fertilization
- Embryo development
- Your age and fertility history
- Your overall family-building goals
Depending on those results, another retrieval may be worth considering. In other situations, moving toward embryo transfer or discussing a different fertility treatment option may make more sense.
The goal is not simply to retrieve a certain number of eggs. It is to understand what your cycle tells us and use that information to guide what comes next.
When Should You See a PREG Fertility Specialist?
A fertility evaluation with PREG can be especially helpful if you have:
- A low AMH or AFC
- A previous low response to IVF stimulation
- Concerns about age-related fertility changes
- A history of ovarian surgery
- Previous chemotherapy or radiation therapy
- A medical condition that may affect ovarian function
- An interest in egg or embryo freezing
Ovarian reserve testing is most useful when it is interpreted alongside your age, medical history, fertility history, and reproductive goals. Looking at all of these factors together gives your fertility specialist a more complete picture and helps you make informed decisions about treatment.
FAQs About Low Egg Reserve
Can low ovarian reserve be reversed?
There is currently no proven fertility treatment that restores the number of eggs remaining in the ovaries. Fertility treatment focuses on making the most of the available ovarian reserve and choosing the approach that best fits your goals.
Can you get pregnant with low AMH?
Yes. A low AMH does not automatically mean you cannot conceive naturally. AMH is primarily useful for estimating ovarian reserve and expected response to fertility medications.
What is the best IVF protocol for low ovarian reserve?
There is no single best protocol. Your fertility specialist may consider your age, AMH, AFC, hormone levels, previous response to stimulation, and overall fertility history when developing your individualized treatment plan.
Can supplements increase egg count?
No supplement has been proven to increase the number of eggs remaining in the ovaries.
Is IVF worth trying with low AMH?
That decision depends on much more than AMH. Your age, AFC, fertility history, sperm factors when applicable, previous fertility treatment response, and reproductive goals all matter.
Does low ovarian reserve mean poor egg quality?
Not necessarily. Ovarian reserve describes egg quantity, while egg quality is a separate consideration. Age is more strongly associated with egg quality and reproductive potential.
Low Egg Reserve? Let’s Talk About What Comes Next
A low ovarian reserve diagnosis is one piece of your fertility picture. It can provide important information about the number of eggs available and how your ovaries may respond to stimulation, but it does not determine your ability to become a parent.
Your options may include IVF, fertility preservation, embryo banking, donor eggs, or other family-building approaches, depending on your individual circumstances. Our fertility specialists look at the full picture: your ovarian reserve testing, age, medical and fertility history, previous treatment response, and goals for building your family.
PREG is the largest network of fertility centers in the Carolinas and has cared for patients for more than 23 years. Our fertility clinic combines individualized treatment planning with advanced, compassionate fertility care and a range of family-building options.
If you have questions about your AMH, AFC, fertility testing, or treatment options, let’s start the conversation. A fertility consultation can help you understand what your results mean and which options may make sense for you.
