Poor responder protocols for in-vitro fertilization: options and results

Area of Science:

• Reproductive Endocrinology
• In-Vitro Fertilization
• Ovarian Stimulation

Background:

• Poor responders represent a significant challenge in in-vitro fertilization (IVF).
• Identifying and managing these patients is crucial for improving IVF success rates.

Purpose of the Study:

• To review current management options for poor responders undergoing IVF.
• To evaluate the efficacy of various controlled ovarian hyperstimulation (COH) protocols.

Main Methods:

• Review of existing literature on COH protocols for poor responders.
• Analysis of outcomes associated with different stimulation strategies.

Main Results:

• No single COH protocol is universally optimal for all poor responders.
• Low-dose gonadotropin-releasing hormone (GnRH) agonist regimens demonstrate advantages.
• Various protocols, including high-dose gonadotropins, flare-up GnRH agonist protocols, stop protocols, luteal onset GnRH agonist, and short protocols, show optimistic results.
• Natural cycle IVF is also a viable consideration.

Conclusions:

• A universal definition of 'poor responder' is lacking.
• Multiple strategies exist to enhance ovarian stimulation, but individualization is key.
• Further high-quality controlled trials are necessary to establish definitive best practices.