I could tell that Amy was upset when I opened the door to my waiting room. A 38-year-old nurse, working at an ICU, she was usually cheerful, despite the stress of her job and the challenges of dealing with infertility over the past two years. Today, however, she was visibly shaken.

“I got the results this morning,” she told me as soon as we sat down. “Of the measly four eggs they retrieved, only three fertilized, and the screening showed that none of the embryos were normal. All this time and money for nothing!” Amy, like many women her age, had a diagnosis of diminished ovarian reserve. The quality and quantity of her eggs, and therefore her chances of getting pregnant, were shrinking. She’d had two previous in vitro fertilization (IVF) cycles, in which she’d injected herself for weeks with a cocktail of medications to release multiple eggs, so they could be clinically retrieved and mixed with her partner’s sperm in the lab, in the hope of growing healthy embryos.

With the first cycle, one of four embryos was healthy and able to be transferred into her uterus. She got pregnant on that try but miscarried at 10 weeks. Her second IVF was similar—only one healthy embryo—but that transfer didn’t result in a positive pregnancy. Most younger women produce 10-12 eggs or more with one IVF cycle. At her age, even with…