title: Choosing the right stimulation protocol for in vitro fertilization-embryo transfer in poor, normal, and hyper-responders.
abstract: OBJECTIVE
  To describe the advantages of low-dose stimulation for poor responders, the pros and cons of low dose vs high dose stimulation for normal responders and multiple strategies for hyper-responders especially to reduce the risk of the ovarian hyperstimulation protocol.
  
  
  METHODS
  Various strategies are described for these three types of responders.
  
  
  RESULTS
  Poor responders do best with mild stimulation protocols. Conventional stimulation protocols for normal responders have the advantage of providing embryos for future embryo transfers assuming the IVF center has a good cryopreservation program. Mild stimulation protocols save money for normal responders. There are many strategies for hyper-responders to prevent ovarian hyperstimulation syndrome including mild stimulation, high LH/FSH ratio for stimulation combination, GnRH agonist instead of hCG and using clomiphene citrate or aromatase inhibitors.
  
  
  CONCLUSIONS
  It is important to choose the right protocol for a given patient. An infertile couple can often help in making the decision.
authors.forename: J H
authors.initials: JH
authors.lastname: Check
authors.forename: B
authors.initials: B
authors.lastname: Slovis
mesh_terms: D047072:Aromatase Inhibitors / Q000008:administration & dosage; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D002996:Clomiphene / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000032:analysis; D006801:Humans; D016471:Ovarian Hyperstimulation Syndrome / Q000517:prevention & control; D011247:Pregnancy; D011256:Pregnancy Outcome
chemical_list: D047072:Aromatase Inhibitors; D006063:Chorionic Gonadotropin; D002996:Clomiphene; D007987:Gonadotropin-Releasing Hormone