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Ovarian Stimulation in Poor Responders: Have We Made Progress?
Robert Roman1, Naiha Mussarat1, Laura Detti1
1University of Tennessee Health Science Center, Department of Obstetrics and Gynecology, Memphis, Tennessee (TN), USA.
Current Pharmaceutical Biotechnology
|October 4, 2017
Summary
Optimizing controlled ovarian stimulation for poor responders (POR) remains challenging. While some protocols show promise, further research is needed to determine the ideal strategy for improving pregnancy rates in this population.
Area of Science:
- Reproductive Endocrinology
- Infertility Treatment
Background:
- Poor ovarian responders (POR) present a significant clinical challenge in assisted reproduction.
- The Bologna criteria established standardized diagnostic criteria for POR, enabling more homogenous patient populations for research.
Purpose of the Study:
- To review and synthesize current literature on controlled ovarian stimulation protocols for poor responders.
- To evaluate the efficacy of various protocols and adjuvant therapies aimed at improving oocyte yield and conception rates in POR patients.
Main Methods:
- A structured literature review focusing on Bologna-defined POR.
- Inclusion of studies evaluating ovarian stimulation protocols and oocyte quality enhancers like CoQ10, DHEA, and GH.
Main Results:
- Controlled ovarian stimulation using aromatase inhibitors and clomiphene citrate demonstrated comparable pregnancy outcomes to high-dose gonadotropins in GnRH antagonist protocols.
- Standardization of POR diagnosis has improved patient population comparability in clinical trials.
Conclusions:
- No single ideal controlled ovarian stimulation protocol has been definitively identified for poor responders.
- Further research is essential to establish optimal treatment strategies for improving pregnancy outcomes in women with poor ovarian response.
