Differentiating clinical profiles: predicting good responders, poor responders, and hyperresponders.
OBJECTIVE
To describe the different clinical and laboratory diagnostic methods (basal and dynamic tests) available to identify poor-, good-, and high-responder patients undergoing treatment with in vitro fertilization (IVF).


METHODS
Analytical review.


METHODS
IVF program.


METHODS
Women in different age groups undergoing IVF treatment.


METHODS
Assessment of clinical and laboratory parameters and correlation with outcomes.


METHODS
Response to ovarian stimulation and success of the assisted reproductive technologies (ART).


RESULTS
Age, basal follicle-stimulating hormone (FSH), estradiol and inhibin-B levels, and dynamic testing serve to predict individual response to ovarian stimulation for ART.


CONCLUSIONS
Markers of ovarian reserve (day 3 FSH, inhibin B and E(2)) are particularly predictive and useful in guiding the choice of the optimal protocol for ART. However, no tests are absolutely predictive of a successful outcome. For the younger individual, and for the patient at risk of developing ovarian hyperstimulation syndrome (OHSS), assessment and identification of clinical and laboratory parameters predictive of a high response to ovarian stimulation should guide the clinician in choosing an appropriate stimulation protocol, thus attenuating the risk of OHSS.
Kligman
I
I
The Center for Reproductive Medicine and Infertility, Weill Medical College of Cornell University, New York, New York 10021, USA. ikligman@med.cornell.edu
Rosenwaks
Z
Z
D000328:Adult; D000367:Age Factors; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007265:Inhibins / Q000097:blood; D008297:Male; D010053:Ovary / Q000502:physiology*; D010062:Ovulation Induction / Q000379:methods*; D018579:Patient Selection; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors
C422364:inhibin B; D004958:Estradiol; D007265:Inhibins; D005640:Follicle Stimulating Hormone