title: How to define, diagnose and treat poor responders? Responses from a worldwide survey of IVF clinics.
abstract: Poor responders represent a significant percentage of couples treated in IVF units (10-24%), but the standard definition of poor responders remains uncertain and consequently optimal treatment options remain subjective and not evidence-based. In an attempt to provide uniformity on the definition, diagnosis and treatment of poor responders, a worldwide survey was conducted asking IVF professionals a set of questions on this complex topic. The survey was posted on www.IVF-worldwide.com, the largest and most comprehensive IVF-focused website for physicians and embryologists. A total of 196 centres replied, forming a panel of IVF units with a median of 400 cycles per year. The present study shows that the definition of poor responders is still subjective, and many practices do not use evidence-based treatment for this category of patients. Our hope is that by leveraging the great potential of the internet, future studies may provide immediate large-scale sampling to standardize both poor responder definition and treatment options.
authors.affiliation: Yale University Fertility Center, New Haven, Connecticut, USA. Electronic address: pasquale.patrizio@yale.edu.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Patrizio
authors.affiliation: Centre for Reproductive Medicine, Vrije University Brussels, Belgium.
authors.forename: Alberto
authors.initials: A
authors.lastname: Vaiarelli
authors.affiliation: Department of Gynecology, Division of Gynecology and Reproductive Medicine, Humanitas Research Hospital Fertility Center, Rozzano, Milan 20084, Italy.
authors.forename: Paolo E
authors.initials: PE
authors.lastname: Levi Setti
authors.affiliation: Department of Gynecology and Obstetrics, Division of Reproductive Endocrinology and Infertility, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Kyle J
authors.initials: KJ
authors.lastname: Tobler
authors.affiliation: Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Gon
authors.initials: G
authors.lastname: Shoham
authors.affiliation: The Women's Clinic, Hong Kong.
authors.forename: Milton
authors.initials: M
authors.lastname: Leong
authors.affiliation: Department of Obstetrics and Gynaecology, Kaplan Medical Center, Rehovot, Israel; Hadassah Medical School, Jerusalem, Israel.
authors.forename: Zeev
authors.initials: Z
authors.lastname: Shoham
mesh_terms: D019317:Evidence-Based Medicine; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D038622:Internationality; D020407:Internet; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D011795:Surveys and Questionnaires
keywords: IVF; decreased ovarian function; management; ovarian stimulation; poor responder; survey