Ovarian stimulation in poor responders

Have we made progress?

Robert Roman, Naiha Mussarat, Laura Detti

Research output: Contribution to journalReview article

Abstract

Background: Poor ovarian responders (POR) pose a challenge to a physicians’ ability to choose a stimulation protocol that maximizes the number of oocytes harvested and their chances of conception with multiple protocols aimed at improving pregnancy rates in this poor prognosis population. The Bologna criteria standardized the diagnosis of POR and allows for a more homogenous patient population in clinical trials. Methods: A structured review of the literature, which encompasses research on Bologna-defined POR, identified several proposed protocols to optimize pregnancy rates in poor responders. In addition, we reviewed the utility of utilizing oocyte quality enhancers such as luteal pre-treatment, coenzyme Q10 (CoQ10), dihydroepiandrosterone (DHEA), and growth hormone (GH). Conclusion: Controlled ovarian stimulation strategies with adjuvant aromatase inhibitors and clomiphene citrate have shown similar pregnancy outcomes to higher dose gonadotropin in GnRH antagonist protocols. While the standardization of Bologna defined POR has allowed for more comparable patient populations to study the effectiveness of different protocols for ovarian stimulation, there is currently no convincing data that has determined the ideal protocol for controlled ovarian stimulation in this patient population. Further research is needed to identify optimal treatment strategies.

Original languageEnglish (US)
Pages (from-to)614-618
Number of pages5
JournalCurrent Pharmaceutical Biotechnology
Volume18
Issue number8
DOIs
StatePublished - Jul 1 2017

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Ovulation Induction
coenzyme Q10
Pregnancy Rate
Population
Oocytes
Clomiphene
Aromatase Inhibitors
Corpus Luteum
Pregnancy Outcome
Gonadotropins
Research
Gonadotropin-Releasing Hormone
Growth Hormone
Clinical Trials
Physicians
Therapeutics

All Science Journal Classification (ASJC) codes

  • Biotechnology
  • Pharmaceutical Science

Cite this

Ovarian stimulation in poor responders : Have we made progress? / Roman, Robert; Mussarat, Naiha; Detti, Laura.

In: Current Pharmaceutical Biotechnology, Vol. 18, No. 8, 01.07.2017, p. 614-618.

Research output: Contribution to journalReview article

Roman, Robert ; Mussarat, Naiha ; Detti, Laura. / Ovarian stimulation in poor responders : Have we made progress?. In: Current Pharmaceutical Biotechnology. 2017 ; Vol. 18, No. 8. pp. 614-618.
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