One of the most difficult aspects of fertilization management is to have reasonable expectations for patients with reduced ovarian reserve before attempting pregnancy by in vitro fertilization (IVF). In some cases, the patient may not accept the doctor’s advice for more effective treatment, such as egg collection. This case report introduces patients who are candidates for poor prognosis  for IVF treatment. She was 43 years old and her 6 IVF cycles failed, with repeated basal FSH values ​​above 30 mIU / ml. Challenges in patient counseling and decision making are presented. In her seventh IVF cycle, where she was highly recommended, the patient experienced the desired outcome of childbirth. There are increasing reports  of births with autologous egg cells in older females.