Patients with a low response typically have an increased challenge to becoming pregnant.
Pre-cycle screening with ovarian reserve tests can help to identify women at risk for a low response before they go through treatment. Many different treatments have been studied to help improve the likelihood of a healthy live birth; as described some are more effective than others. Incorporating a holistic approach to one’s family building often helps to mitigate any extra stress a person may be feeling. Lastly, the use of an egg donor may be appropriate for certain patients and will greatly increase the chance of pregnancy to that of a younger woman in her early 30’s.
Pre-cycle screening with ovarian reserve tests can help to identify women at risk for a low response before they go through treatment. Many different treatments have been studied to help improve the likelihood of a healthy live birth; as described some are more effective than others. Incorporating a holistic approach to one’s family building often helps to mitigate any extra stress a person may be feeling. Lastly, the use of an egg donor may be appropriate for certain patients and will greatly increase the chance of pregnancy to that of a younger woman in her early 30’s.
Latest Criteria For A poor responder-
At least two of the following three features must be present:
At least two of the following three features must be present:
Advanced maternal age (≥40 years of age) or any other risk factor for a poor ovarian response
A prior poor ovarian response (≤3 oocytes with a conventional stimulation protocol), and
An abnormal ovarian reserve test (ie., antral follicle count
A prior poor ovarian response (≤3 oocytes with a conventional stimulation protocol), and
An abnormal ovarian reserve test (ie., antral follicle count
Women who respond poorly to controlled ovarian hyperstimulation present a challenge. Some patients may benefit from additional interventions described below, while others, particularly those women with a recurrent poor response, will require the use of a donor egg to complete their goal of family building. Having a poor response to controlled ovarian hyperstimulation (COH) is quite frustrating for the patient and the inclusion of a support group or behavioral health specialist into a patient’s treatment plan is often encouraged.
Treatment for a Low Ovarian Response:
Different treatments for a poor response to ovarian stimulation can be grouped as follows:
Different treatments for a poor response to ovarian stimulation can be grouped as follows:
altering the pituitary down regulation protocols,
modifying stimulation cycle medications (e.g., different types and amounts gonadotropins),
use of adjuvant therapy (such as, growth hormone or androgen pretreatment),role of DHEA still not clear, and
inclusion of advanced laboratory techniques (e.g., assisted hatching, continuing to egg retrieval despite low follicle numbers, or day 2 transfers).
modifying stimulation cycle medications (e.g., different types and amounts gonadotropins),
use of adjuvant therapy (such as, growth hormone or androgen pretreatment),role of DHEA still not clear, and
inclusion of advanced laboratory techniques (e.g., assisted hatching, continuing to egg retrieval despite low follicle numbers, or day 2 transfers).
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