[Which stimulation for poor responders? Critical study of results and methods of research].
No therapeutic approach is regularly effective to correct poor ovarian responses. High gonadotropin doses from the beginning of stimulation can increase plasma estradiol level and number of preovulatory follicles, but generally fail to improve ongoing pregnancy rate, in ovulation induction and in vitro fertilization as well. LHRH agonists in long protocol gave in our experience the best results. In short protocol their "flare-up" effect is useful, but plasma LH and progesterone are also increased in follicular phase. The clomiphen citrate--hMG association is more effective on oocyte and embryo quality than quantity. Results of spontaneous cycle and growth hormone or GRF co-treatment are disappointing. Using GnRH agonist micro-doses needs for more precise assessment. Oocyte donation can be the last solution for some of these patients.
Antoine
J M
JM
Service de Gynécologie-Obstétrique, Hôpital Tenon, Paris.
D000328:Adult; D002985:Clinical Protocols; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D012107:Research Design; D012189:Retrospective Studies; D017211:Treatment Failure
Quelle stimulation pour les mauvaises répondeuses? Etude critique des résultats et voies de recherche.