IVF by Age & Patient Profile
Being a "poor responder" in IVF, producing fewer eggs than expected despite stimulation is challenging, but it is not a closed door. Here is what it means and what your options are.
POSEIDON Classification for poor responders (2016) indicates that poor responders retrieve less than 4 eggs during standard stimulation cycles, or < 5 follicles during the baseline ultrasound scan (Low AFC) along with AMH level less than 1.2 ng/ml. The risk of being a poor responder increases after the age of 38, but it could happen at any age because poor responders have low ovarian reserve (number of eggs available). Poor ovarian reserve decreases over time with age; however, other factors such as genetics, surgeries, and chemotherapy could lead to poor ovarian reserve.
Maximum FSH with dual stimulation (Duostim cycle – stimulation twice in one cycle to harvest more eggs in multiple retrievals). Mini IVF – low dose stimulation to obtain fewer but high-quality eggs. Priming before the cycle with DHEA or growth hormones (evidence is weak but sometimes useful in complicated situations). LH supplementation along with FSH treatment in poor responders with lower LH levels (Menopur/Pergoveris).
If multiple cycles have produced very few eggs and no euploid embryos, donor egg IVF offers significantly higher per-cycle success rates. For women under 40 with poor response, own-egg IVF with cumulative retrieval (banking embryos from multiple cycles) is often tried before donor eggs are discussed. For women over 42, the conversation about donor eggs should happen earlier not as a final resort, but as a genuine, comparable option.
Q: Can I improve my ovarian reserve?
A: There is no proven method to increase the number of eggs in your reserve. Some supplements (CoQ10, DHEA) may modestly improve the quality of available eggs, but they do not create new eggs. A healthy lifestyle and minimising environmental toxin exposure support the eggs you have.
Q: Is mini IVF a better option for poor responders?
A: Mini IVF is lower cost per cycle but produces fewer eggs. For poor responders who already have few eggs in a full cycle, mini IVF may not produce significantly fewer and its reduced medication burden may suit some patients. The evidence does not show a clear overall advantage.
Q: My AMH is 0.4 should I still try IVF?
A: AMH of 0.4 indicates low reserve but does not mean zero eggs. Many women with AMH between 0.3 and 1.0 retrieve useful numbers of eggs with an optimised protocol. A consultation with an experienced specialist is the best next step.
There is no proven method to increase the number of eggs in your reserve. Some supplements (CoQ10, DHEA) may modestly improve the quality of available eggs, but they do not create new eggs. A healthy lifestyle and minimising environmental toxin exposure support the eggs you have.
Mini IVF is lower cost per cycle but produces fewer eggs. For poor responders who already have few eggs in a full cycle, mini IVF may not produce significantly fewer and its reduced medication burden may suit some patients. The evidence does not show a clear overall advantage.
AMH of 0.4 indicates low reserve but does not mean zero eggs. Many women with AMH between 0.3 and 1.0 retrieve useful numbers of eggs with an optimised protocol. A consultation with an experienced specialist is the best next step.
