IVF Stimulation: Protocols for Poor Responders

One of the most vexing challenges in the practice of reproductive medicine is the management of the “poor responder,” specifically the patient manifesting an inadequate follicular response to ovarian stimulation. Poor response predicts a reduction in the number of mature oocytes retrieved, with the consequences of fewer embryos available for selection and transfer, reduced pregnancy rates, and a markedly decreased likelihood of residual embryos for cryopreservation. This chapter reviews the definition and prediction of poor response and discusses strategies that have been developed and incorporated into the reproductive endocrinologist’s clinical armamentarium in an effort to optimize outcomes for these women. It should be stated at the outset that no single approach is successful for all patients, and that there is currently no firm clinical consensus regarding the relative efficacy of the different stimulation protocols. This arises in part due to inconsistency regarding the definition of what constitutes a poor response and a paucity of well-designed, randomized controlled trials.

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  1. Weill Medical College of Cornell University, Center of Reproductive Medicine and Infertility, 1305 York Avenue, New York, NY, 10021, USA Owen K. Davis M.D.
  1. Owen K. Davis M.D.
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Editors and Affiliations

  1. The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, New York, USA Zev Rosenwaks
  2. Dept. Developmental & Regenerative Biology, Ichan School of Medicine at Mount Sinai, New York, New York, USA Paul M. Wassarman

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Davis, O.K. (2014). IVF Stimulation: Protocols for Poor Responders. In: Rosenwaks, Z., Wassarman, P. (eds) Human Fertility. Methods in Molecular Biology, vol 1154. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-0659-8_15

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