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[Poor responders: How could we improve our results?]
M Duport Percier1, T Anahory1, N Ranisavljevic1
1Unité de gynécologie obstétrique, médecine et biologie de la reproduction, pôle hospitalo-universitaire, naissance et pathologie de la femme, CHRU Arnaud-de-Villeneuve, 371, avenue du Doyen-Gaston-Giraud, 34090 Montpellier, France.
Gynecologie, Obstetrique, Fertilite & Senologie
|April 4, 2017
Summary
For poor responders in assisted reproductive technology, the antagonist protocol offers advantages. While no ideal treatment exists, dehydroepiandrosterone (DHEA) shows promise for improving pregnancy rates.
Area of Science:
- Reproductive Endocrinology
- Assisted Reproductive Technology (ART)
Background:
- Managing poor responders in ART remains a significant clinical challenge.
- The Bologna consensus (2011) standardized the definition of poor ovarian response (POR).
Purpose of the Study:
- To objectively assess current treatment options for poor responders in assisted reproductive technology.
- To review the efficacy of various protocols and adjunctive therapies.
Main Methods:
- A comprehensive literature search was conducted in the PubMed database.
- Studies published in English between October 2000 and April 2016 were included.
Main Results:
- The antagonist protocol is favored due to better patient tolerance, reduced gonadotropin dosage, and shorter stimulation duration.
- Increasing daily gonadotropin doses above 300 IU or using specific gonadotropin types showed no additional benefit.
- Dehydroepiandrosterone (DHEA) may enhance embryonic quality and pregnancy rates, but requires further investigation.
Conclusions:
- No single ideal protocol exists for managing poor responders.
- Emerging strategies like oocyte banking and dual stimulation offer potential new avenues for treatment.
- Further research is needed to validate the efficacy of DHEA and novel approaches.