There are times when your physician recommends that you do not start an IVF cycle using your own eggs. The American Society of Reproductive Medicine Ethics committee suggests that there are situations in which IVF with your own eggs is futile (1 percent or less live birth rate) or of very poor prognosis (1 percent to 5 percent live birth rate).

In these situations the American Society for Reproductive Medicine suggests the most ethical thing for a physician to do is to recommend against treatment. The reasons for this include:

• potential risks from treatment outweigh the benefits of a very low chance for a successful pregnancy
• medical risks from the procedure (infection, bleeding, injury to bowel or bladder, and anesthetic risks)
• financial risks (each treatment is very expensive)
• emotional toll from treatment that has very little chance for success

When patients consider whether to proceed with treatment that will give them less than a 1 in 20 chance to have a child, they need to consider how this treatment may affect them, and their ultimate stamina to then continue treatment with donor eggs or adoption.

There are clinical situations in which the chance of a successful pregnancy is less than 5 percent. If you are in one of these groups, we would highly recommend not undertaking treatment using your own eggs:

• Women over 43 years of age
• Women over 42 year of age with any one of the following: FSH > 9, AMH < 1.0, Antral Follicle Count (AFC) < 10
• Women over 40 years of age with FSH > 9, AMH < 0.6 or AFC < 8
• Women 38-40 years of age with FSH > 14, AMH < 0.1, AFC < 5