In vitro fertilization following natural cycles in poor responders

Different ovarian stimulation protocols for women with diminished ovarian reserve

“…The results of two prospective studies [171,178] support the hypothesis that the naturally developed follicles of poor responders may produce fewer oocytes but oocytes of better quality than their hyperstimulated ovaries. It is clear that, in poor responders, natural cycle is superior once an oocyte has been retrieved and fertilization and implantation rates are significantly better.…”

Modified Natural Cycle Using GnRH Antagonist Can Be an Optional Treatment in Poor Responders Undergoing IVF

“…No convincing advantage for one protocol over another has been established to date (18). We have recently described our results using natural cycles in poor responder patients, and showed a success rate of 20% (11). The discovery of GnRH receptors in the ovary led to the assumption by some investigators that GnRH agonists may have a direct and unfavorable effect on the ovary, a factor that could be particularly critical for poor responders to IVF-ET treatment (8).…”

“…All the women signed an informed consent to participate. Poor response was defined as ≤4 oocytes obtained at ovum pick-up (OPU) or an E2 level <1000 pg/mL on the day of human chorionic gonadotrophin (hCG) administration (11). Treatment protocols were chosen according to periods.…”

“…IVF following natural cycles was reported to be as valuable as stimulated cycles in poor responders. The main concern about natural IVF cycles is the disadvantage of a high cancellation rate because of premature luteinizing hormone (LH) surges (11). There are limited data on the use of GnRH antagonists for preventing premature luteinization in natural cycles of poor responders.…”

Minimal stimulation using gonadotropin-releasing hormone (GnRH) antagonist and recombinant human follicle-stimulating hormone versus GnRH antagonist multiple-dose protocol in low responders undergoing in vitro fertilization/intracytoplasmic sperm injection

“…However, whatever COS protocol is used, low responders who are characterized by a diminished ovarian reserve (1) most commonly require a large dose of gonadotropins and also fail to respond adequately. Therefore, they may benefit from natural cycle IVF treatment (2,3). Natural cycle IVF is low risk and patient friendly and moreover allows the transfer of a single embryo into a more physiologic and receptive endometrial environment.…”