Women with diminished ovarian reserve often face an uphill battle with IVF, as standard protocols may not deliver the desired results. But fertility science is evolving, and promising new approaches are changing the game.
Breakthrough treatments like Bio IVF, ovarian PRP therapy, Stem Cell Ovarian Rejuvenation, and In Vitro ovarian Activation (IVA) are bringing fresh hope to those with low ovarian reserves.
So, what are the best ways to boost IVF success when ovarian reserves are running low? What are the best low ovarian reserve IVF treatments? Let’s dive into the most effective strategies.
How Do You Know If You Have Low Ovarian Reserve?
Before choosing an IVF protocol or a regenerative fertility treatment, doctors evaluate ovarian reserve through:
🩸 AMH (Anti-Müllerian Hormone) – Measures how many follicles and eggs remain in your ovaries.
🖥 Antral Follicle Count (AFC) – An ultrasound to count the small follicles that could develop into eggs.
📊 FSH & Estradiol (E2) Levels – High FSH can indicate diminished ovarian function, as well as low Estradiol levels.
💡 Inhibin B – An additional marker of ovarian activity.
These tests help doctors personalize the best treatment approach.
Best Low Ovarian Reserve IVF Treatments and Protocols
1. Long Agonist Protocol
✔ Uses small doses of GnRH agonists (buserelin, leuprolide) to prep the ovaries before stimulation.
✔ May help recruit more follicles.
❌ Can overly suppress ovarian function in some cases.
2. Antagonist Protocol (Short Protocol)
✔ A more flexible approach that uses GnRH antagonists (cetrorelix, ganirelix) at a key stage of stimulation.
✔ Reduces the risk of premature ovulation.
❌ May yield fewer eggs compared to longer protocols.
3. Mild Stimulation IVF
✔ Uses lower doses of hormones or a mix with letrozole or clomifen to avoid excessive suppression.
✔ May improve egg quality.
❌ Typically results in fewer eggs retrieved per cycle.
4. Natural & Modified Natural IVF
✔ Works with your body’s natural cycle (little or no hormone stimulation).
✔ Fewer side effects and lower costs.
❌ Produces very few eggs per cycle.
5. Double Stimulation (DuoStim / Shanghai Protocol)
✔ Involves two stimulations in one cycle—one during the follicular phase, another in the luteal phase.
✔ Maximizes egg retrieval in a short time.
❌ Requires intensive hormonal treatment.
Regenerative Therapies & Bio IVF
🩸 PRP (Platelet-Rich Plasma) therapy (sometimes with direct hormonal stimulation) involves injecting a patient’s own platelet-rich plasma into the ovaries to enhance follicular function.
✔ May boost ovarian response in women with low AMH.
✔ A minimally invasive, promising treatment.
🧬 Uses stem cells from bone marrow or blood to restore ovarian function.
✔ Mesenchymal stem cells (MSC) help stimulate follicle growth.
✔ Hematopoietic stem cells (HSC) improve ovarian blood flow and tissue repair.
❌ Not an established therapy, but the research results are promising.
🔬 In Vitro Activation of ovarian tissue (IVA) involves removing ovarian tissue, activating it in a lab, and reimplanting it to wake up dormant follicles.
✔ A cutting-edge option for primary ovarian insufficiency (POI).
❌ Requires highly specialized centers and is still in limited use.
What is the Best Approach?
There’s no one-size-fits-all protocol for diminished ovarian reserve. The best strategy depends on your ovarian function, medical history, and fertility goals.
💡 Bio IVF (PRP therapy) – Good for women with moderate ovarian decline.
🧬 Mesenchymal + Hematopoietic Stem Cell Therapy – Ideal for severely diminished reserve.
🔬 IVA (In Vitro Activation) – Best for cases of primary ovarian insufficiency (POI).
If you’re struggling with low ovarian reserve, talk to a fertility specialist about combining traditional IVF with regenerative therapies for the best chances of success.
📢 Have you tried any of these approaches? Share your experience in the comments!
professor Aleksandar Ljubic
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