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IVF with Poor Ovarian Response

IVF With Poor ovarian response

IVF with poor ovarian response refers to the process of in vitro fertilization (IVF) in women who have a reduced ovarian reserve or who respond poorly to ovarian stimulation during the IVF cycle. Poor ovarian response can be due to various factors including advanced maternal age, previous ovarian surgery, certain medical conditions, or genetic factors.

To address poor ovarian response, fertility specialists may employ different strategies to optimize the chances of success:

Introductions to Ovarian Reserve Testing (ORT)

ORT helps in determining a woman’s ability to conceive by analyzing her ovarian reserve.

Hormonal indicators:

AMH, Inhibin A, and Inhibin B are essential hormones that provide insights into a woman’s ovarian reserve and fertility potential.


Anti-Müllerian Hormone serves as a reliable marker for ovarian reserve as it remains relatively stable throughout the menstrual cycle.

Inhibin A and Inhibin B:

These hormones regulate FSH levels and provide additional information about follicle development and ovarian reserve.

Age factor:

A woman’s age is a significant determinant of her fertility potential, as ovarian reserve decreases with age.

Early evaluation:

ORT can help identify potential fertility issues early on, allowing for timely interventions and treatment options.

Antral and Preantral Follicles

Follicle development stages:

Antral and preantral follicles represent different stages in the development of ovarian follicles.

Preantral follicles:

These are immature follicles in the early stages of development, not yet visible on ultrasound.

Antral follicles:

These are mature, fluid-filled follicles visible on ultrasound, capable of responding to hormonal stimulation for further growth.

Role in ORT:

The number of antral and preantral follicles provides valuable information about a woman’s ovarian reserve and fertility potential.

Antral Follicle Count (AFC):

This count is obtained through a transvaginal ultrasound and serves as an essential tool in assessing ovarian reserve.

Fertility potential:

A higher number of antral and preantral follicles indicates a better fertility potential and a greater likelihood of successful ovarian stimulation.

Ovarian stimulation response:

The number of these follicles helps predict a woman’s response to fertility treatments, allowing for personalized treatment plans.

Essential fertility hormones such as

  • FSH
  • LH
  • TSH
  • PRL
  • Estradiol
  • Progesterone
  • Ovarian Stimulation Protocols

  • Long protocol
  • Short protocol
  • Flare protocol
  • Medications for Ovarian Stimulation

  • Clomiphene
  • Letrozole
  • Gonadotrophin
  • GnRH Agonists
  • Antagonists
  • Ovarian Failure and Premature Ovarian Failure (POF)

  • Ovarian failure refers to the loss of normal ovarian function
  • Premature Ovarian Failure (POF) occurs when this loss happens before the age of 40.
  • Causes:
  • Genetic factors
  • autoimmune conditions
  • infections
  • cancer treatments
  • other environmental factors
  • Treatment:

    Hormone replacement therapy (HRT) can help manage symptoms and protect against long-term health risks, such as osteoporosis.

    Alternative fertility methods:

  • Donor eggs
  • IVF
  • adoption of the child
  • Ovulation Induction (OI) and Ovarian Response

    Criteria to assess the risk of poor ovarian response (POR) in fertility treatments:
  • Bologna
  • Poseidon
  • Advanced techniques such as ASE and ART to enhance the success rate of fertility treatments, particularly for women with POR or other challenges.

    Whether you’re a healthcare professional or an individual seeking fertility advice, this video is your ultimate guide to ovarian reserve and fertility treatments.