I was given two cycles of fertility drugs in preparation for IVF. Both times I had a very small number of eggs (three and then two). The doctor said that because I was not reacting to the stimulation drugs, I am not a candidate for IVF. How can this happen? What do I do now?

C.D.

The most common reason for failure to respond to IVF drug-stimulation protocols is age. There is presently no approach to reverse genetically programmed age-related infertility. The one possible reversible cause is the unexplained presence of anti-ovarian antibodies. A simple blood test can identify this and determine if you may benefit from a short course of steroid therapy to reverse ovarian dysfunction.

You would do best to consider IVF with egg donation. Egg donation requires either a known donor of proven fertility or an anonymous donor selected through a program that can provide screening. The egg donor will undergo the drug-stimulation protocols and egg retrieval procedure while the development of your uterine lining is synchronized to be ready to accept two well-developed embryos. While this procedure is costly -- ranging from $15,000-20,000 in most IVF programs -- the live birth rates per treatment cycle can approach 50 percent or above.