Hope With Fewer Eggs
Diminished ovarian reserve (DOR) is when a woman has fewer eggs left in the ovaries compared to other women the same age. Women with DOR may have diminished egg quality, egg quantity, or both. This condition may occur naturally with age or result from medical treatments, genetics, or certain health conditions. Diagnosis often involves hormone testing, where anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH) are both measured. A low egg count can limit the chances of pregnancy, but intrauterine insemination (IUI) may provide a solution for hopeful couples.
Sperm, meet egg
Intrauterine insemination involves placing washed and concentrated sperm directly into the uterus during ovulation. The goal is to improve the chances of fertilization by bringing sperm closer to the egg. IUI is often combined with the use of fertility medications to stimulate ovulation and encourage follicle growth. For women with low egg count, IUI with medication may be enough to achieve a pregnancy.
IUI success rates
Overall success rates with IUI depend on age, egg quality, and ovarian response. In patients under age 30, IUI success rates typically hover around 17%, while women over 40 are thought to conceive only about 5% of the time. If a patient has DOR, the chances of success may drop slightly. Repeated IUI cycles may offer cumulative benefits, but live birth rates often remain modest with low ovarian reserve. A fertility specialist may recommend no more than 3–4 IUI attempts before considering other options.
When IVF becomes the better path
In vitro fertilization (IVF) offers higher success rates, particularly when ovarian reserve is low. IVF involves retrieving multiple eggs after stimulation, fertilizing the eggs in a lab, and transferring the healthiest embryo into the uterus. This method allows more control over timing and embryo selection. For individuals under 35, IVF success rates may reach 40-55% per cycle, while women over 35 typically see success closer to 20-30% of the time. Preimplantation genetic testing (PGD), assisted hatching, and other add on procedures may further increase the chances of success.
Advanced strategies for low reserve
Women with a limited number of eggs may benefit from additional strategies that support success. Certain supplements, such as coenzyme Q10 (CoQ10), may help increase the chances of conception. Some clinics recommend early retrieval to preserve viable eggs before further decline. Embryo banking over multiple cycles may also build a stronger cohort for transfer. Other options include the use of donor eggs or dual stimulation protocols. Choosing a clinic with expertise in DOR cases can improve the chances of success.
Moving forward with clarity
Low ovarian reserve presents unique challenges, but pathways still exist for building a family. In mild cases, IUI may be appropriate, though success rates remain limited. IVF provides greater flexibility and often results in higher pregnancy rates. A tailored plan, based on age, lab results, history of fertility treatment, and individual response, can help maximize results while minimizing emotional strain.
