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Poor Ovarian Response to Stimulation for In Vitro Fertilization

Srpski arhiv za celokupno lekarstvo, 2015-05, Vol.143 (5-6), p.354-361

ISSN: 0370-8179 ;EISSN: 2406-0895 ;DOI: 10.2298/SARH1506354S ;PMID: 26259413

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Title:
Poor Ovarian Response to Stimulation for In Vitro Fertilization
Author: Spremović-Radjenović, Svetlana ; Bila, Jovan ; Gudović, Aleksandra ; Vidaković, Snežana ; Dokić, Milan ; Radunović, Nebojša
Subjects: Adult ; Anti-Mullerian Hormone - blood ; Female ; Fertilization in Vitro - methods ; Follicle Stimulating Hormone - blood ; follicular reserve ; Humans ; in vitro fertilization (IVF) ; Infertility, Female - blood ; Infertility, Female - therapy ; Ovary - physiology ; Ovulation Induction - methods ; poor ovarian response ; Pregnancy ; Pregnancy Rate ; Prognosis ; therapeutic protocols ; Treatment Outcome
Is Part Of: Srpski arhiv za celokupno lekarstvo, 2015-05, Vol.143 (5-6), p.354-361
Description: The term "poor respond (POR) patients" is used for the group of women who respond badly to usual doses of gonadotropins in in vitro fertilization (IVF) treatments; the consequence is low pregnancy rate. A consensus was reached on the minimal criteria needed to define POR. At least two of the following three features must be present: 1. advanced maternal age (40 years or more) 2. previous POR (3 or less oocytes with a conventional stimulation protocol) 3. abnormal ovarian reserve (AMH 0.5-1.1 ng/ml or AFC 5-7).The aim is to find better therapeutic options for these patients. Increased levels of day 3 follicle stimulating hormone (FSH) and estradiol (E2), as well as decreased levels of anti-Müllerian hormone (AMH) and antral follicle count (AFC), can be used to assess ovarian reserve, as indirect predictive tests. A larger number of well designed, large scale, randomized, controlled trials are needed to assess the efficacy of different management strategies for poor responders: flare up gonadotropin releasing hormone (GnRH) agonist protocols, modified long GnRH agonist mini-dose protocols, luteal initiation GnRH agonist stop protocol, pretreatment with estradiol--GnRH antagonist in luteal phase, natural cycle aspiration or natural cycle aspiration GnRH antagonist controlled, adjuvant therapy with growth hormone or dehydroepiandrosterone (DHEA). The results of up to now used protocols are unsatisfactory and stimulation of the ovulation in poor responders remains a challenge, especially when bearing in mind that in the majority of cases the patients will be menopausal in relatively short period of time.
Publisher: Serbia: Serbian Medical Society
Language: Serbian;English
Identifier: ISSN: 0370-8179
EISSN: 2406-0895
DOI: 10.2298/SARH1506354S
PMID: 26259413
Source: DOAJ Directory of Open Access Journals
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Poor Ovarian Response to Stimulation for In Vitro Fertilization

ISSN: 0370-8179 ;EISSN: 2406-0895 ;DOI: 10.2298/SARH1506354S ;PMID: 26259413

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