Poor responders in assisted reproduction cycles

Poor responders represent a challenging group of infertility patients who fail to respond to controlled ovarian hyperstimulation during the course of assisted reproduction treatment. Although poor response has been investigated since the eighties, many aspects of this condition are still controversial and no consensus has been reached on the management of these patients. The existing data cannot be easily compared due to the heterogeneity of the research design and methodology and the number of prospective randomized trials of sufficient sample size is limited. In addition, more research in the identification and understanding of underlying factors is needed together with a better understanding of the patho-physiological basis of ovarian ageing and of the progressive reduction in ovarian reserve. This paper provides an overview on the identification, prediction and management of poor responders undergoing medicated assisted reproduction treatment.