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[Poor responders: How could we improve our results?]

Authors
  • Duport Percier, M1
  • Anahory, T1
  • Ranisavljevic, N1
  • Bringer-Deutsch, S2
  • 1 Unité de gynécologie obstétrique, médecine et biologie de la reproduction, pôle hospitalo-universitaire, naissance et pathologie de la femme, CHRU Arnaud-de-Villeneuve, 371, avenue du Doyen-Gaston-Giraud, 34090 Montpellier, France. , (France)
  • 2 Unité de gynécologie obstétrique, médecine et biologie de la reproduction, pôle hospitalo-universitaire, naissance et pathologie de la femme, CHRU Arnaud-de-Villeneuve, 371, avenue du Doyen-Gaston-Giraud, 34090 Montpellier, France. Electronic address: [email protected] , (France)
Type
Published Article
Journal
Gynecologie, obstetrique, fertilite & senologie
Publication Date
Feb 01, 2017
Volume
45
Issue
2
Pages
95–103
Identifiers
DOI: 10.1016/j.gofs.2016.12.023
PMID: 28368802
Source
Medline
Keywords
Language
French
License
Unknown

Abstract

Finding an efficient treatment for poor responders still poses a tremendous challenge for assisted reproductive technology. In 2011, an international consensus has been reached in Bologna on how to standardize the definition of poor ovarian response (POR) in a simple and reproducible manner. This article provides an objective assessment of the different treatment options currently available. A search of the database PUBMED was carried out for studies published in English between October 2000 and April 2016. There is no ideal protocol to manage poor responders even though the antagonist protocol seems to have an advantage of clinicians. This is thanks to better patient tolerance and reduced total dose of gonadotrophin as well as shorter time of stimulation. It seems that there is no benefit in increasing the gonadotrophin daily doses over 300IU nor using any specific type of gonadotrophin. Today, there is insufficient evidence to recommend any additional treatment for poor responders. Only dehydroepiandrosterone (DHEA) seems to increase embryonic quality and pregnancy rate, however further exploration and complementary prospective studies are necessary. New treatment strategies such as "oocyte banking" or double stimulation during the same cycle, could provide new prospects in poor responders management. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

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