title: [Poor responders: How could we improve our results?]
abstract: OBJECTIVE
  Finding an efficient treatment for poor responders still poses a tremendous challenge for assisted reproductive technology. In 2011, an international consensus has been reached in Bologna on how to standardize the definition of poor ovarian response (POR) in a simple and reproducible manner. This article provides an objective assessment of the different treatment options currently available.
  
  
  METHODS
  A search of the database PUBMED was carried out for studies published in English between October 2000 and April 2016.
  
  
  RESULTS
  There is no ideal protocol to manage poor responders even though the antagonist protocol seems to have an advantage of clinicians. This is thanks to better patient tolerance and reduced total dose of gonadotrophin as well as shorter time of stimulation. It seems that there is no benefit in increasing the gonadotrophin daily doses over 300IU nor using any specific type of gonadotrophin. Today, there is insufficient evidence to recommend any additional treatment for poor responders. Only dehydroepiandrosterone (DHEA) seems to increase embryonic quality and pregnancy rate, however further exploration and complementary prospective studies are necessary.
  
  
  CONCLUSIONS
  New treatment strategies such as "oocyte banking" or double stimulation during the same cycle, could provide new prospects in poor responders management.
authors.affiliation: Unité de gynécologie obstétrique, médecine et biologie de la reproduction, pôle hospitalo-universitaire, naissance et pathologie de la femme, CHRU Arnaud-de-Villeneuve, 371, avenue du Doyen-Gaston-Giraud, 34090 Montpellier, France.
authors.forename: M
authors.initials: M
authors.lastname: Duport Percier
authors.affiliation: Unité de gynécologie obstétrique, médecine et biologie de la reproduction, pôle hospitalo-universitaire, naissance et pathologie de la femme, CHRU Arnaud-de-Villeneuve, 371, avenue du Doyen-Gaston-Giraud, 34090 Montpellier, France.
authors.forename: T
authors.initials: T
authors.lastname: Anahory
authors.affiliation: Unité de gynécologie obstétrique, médecine et biologie de la reproduction, pôle hospitalo-universitaire, naissance et pathologie de la femme, CHRU Arnaud-de-Villeneuve, 371, avenue du Doyen-Gaston-Giraud, 34090 Montpellier, France.
authors.forename: N
authors.initials: N
authors.lastname: Ranisavljevic
authors.affiliation: Unité de gynécologie obstétrique, médecine et biologie de la reproduction, pôle hospitalo-universitaire, naissance et pathologie de la femme, CHRU Arnaud-de-Villeneuve, 371, avenue du Doyen-Gaston-Giraud, 34090 Montpellier, France. Electronic address: s-bringer_deutsch@chu-montpellier.fr.
authors.forename: S
authors.initials: S
authors.lastname: Bringer-Deutsch
mesh_terms: D002985:Clinical Protocols; D003687:Dehydroepiandrosterone / Q000008:administration & dosage; D005260:Female; D006062:Gonadotropins / Q000008:administration & dosage; D006801:Humans; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D018873:Pregnancy Rate; D027724:Reproductive Techniques, Assisted / Q000639:trends*; D016896:Treatment Outcome
chemical_list: D006062:Gonadotropins; D003687:Dehydroepiandrosterone
keywords: Adjuvant therapy; Androgens; Androgènes; Assistance médicale à la reproduction; Assisted reproductive techniques; Mauvaises répondeuses; Ovarian stimulation; Poor responders; Stimulation ovarienne; Traitements adjuvants