Step-by-Step
Often seen as a low antral follicle count (AFC), low AMH, and/or elevated FSH. DOR can feel like an urgent, discouraging diagnosis, but it does not automatically mean pregnancy is out of reach. At Hanabusa, DOR care starts with two priorities: (1) confirm what DOR does—and does not—explain, and (2) build a plan that improves access to eggs without compromising quality.
We focus on egg access + quality protection—with protocols designed to avoid overstimulation, preserve the dominant follicle, and reduce cycle cancellations.
If you’re cycling regularly, DOR may not be the only reason you’re not conceiving—so we evaluate the full picture, not just the numbers.
We avoid pushing FSH to extremes that can interfere with follicle maturation (“overstimulation syndrome” in our clinical experience).
We don’t default to “sacrificing” the lead follicle to chase a larger cohort—because in DOR, that lead follicle may be your best opportunity.
When there are only 1–2 follicles, technique matters—follicle flushing may be used to reduce the chance of missing an egg.
DOR rarely improves, so we consider egg/embryo banking when it supports your family goals and timeline.
Patient Success Story - How Low Complexity IVF Can Help Women with Diminished Ovarian Reserve
Your AMH is low, AFC is low, and/or FSH is elevated
You’ve been told your cycle may be canceled unless you produce “enough” follicles
You’ve had poor response to high-dose stimulation (or felt worse with higher meds)
You’re 35+ or you feel time-sensitive and want a clear strategy
You want a plan that balances immediate pregnancy goals with future family planning
Your reserve markers are reassuring and your primary issue appears to be elsewhere (tubal, uterine, male factor, timing)—we’ll guide you to the most direct fix
You’re not ready for treatment yet and want a preservation-first strategy (we can plan proactively)
Type of IVF strategy recommended (gentle vs. conventional stimulation)
Monitoring needs (ultrasounds + labs)
Fertilization approach (ICSI may be recommended in DOR cases)
Embryo freezing/storage and whether banking is part of the plan
Any uterine or diagnostic procedures needed before transfer
Often included: physician oversight, retrieval procedure, standard lab steps (package-dependent)
Often separate: medications, some monitoring, ICSI, PGT, freezing/storage, FET cycle
DOR affects access to eggs, not automatically egg quality—especially at younger ages. Success depends on creating the right opportunities and using a strategy that avoids cancellation and protects follicle maturation.
Age (a major driver of embryo chromosomal health)
Underlying infertility factors beyond DOR (uterine/tubal/sperm/timing)
Protocol choice (avoiding overstimulation and overmaturation)
Number of eggs retrieved across time (including banking strategy)
Transfer environment and timing (fresh vs. frozen strategy as indicated)
More monitoring precision when follicle numbers are low (timing matters)
Designed to support maturation without pushing you into an unhelpful “more is better” range
Outpatient procedure with a strategy suited to low follicle counts (including flushing when appropriate)
Fertilization planning (often ICSI), then transfer planning or banking plan depending on goals
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You’re a fit for Traditional Fertility Care if any of these statements resonate with you:
You’re just getting started
You want clear first steps
You’ve explored clinics, but still feel at the beginning
You need fertility testing
Your labs look reassuring
Your situation feels straightforward
You have fewer complicating factors
You’re considering IUI
You’re new to IVF
You’re planning an FET
You’re considering PGT
If anything, complex becomes evident, we smoothly upgrade your pathway.
You’re a fit for Complex Care if any of these statements resonate with you:
Low AMH/AFC or DOR concerns
You have Diminished Ovarian Reserve (DOR)
You have POI or high FSH concerns
You’re considering Ovarian Rejuvenation (PRP)
Age 40+ or time feels limited
Prior IVF didn’t respond as hoped
Low egg numbers / embryo growth issues
Unsuccessful embryo transfers
Recurrent pregnancy loss (2+ losses)
Male factor needs ICSI or TESE
You’ve been told your case is complex
If your case is complex from the start, we build the right strategy from day one.
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