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"Poor Response" to IVF Stimulation? Look for the Root Cause

Many women who struggle to get pregnant, even with IVF, are diagnosed as “poor responders.” This label means that their ovaries respond poorly to ovarian stimulation. At CHR, we feel that this easy “diagnosis” simply describes what’s happening, and doesn’t necessarily lead to addressing the root cause, and, is not very helpful in really helping women have a successful pregnancy.

Why you might be a "poor responder"

There are many reasons a woman could be a "poor responder" to infertility treatment. A few possibilities include:

  • too little ovarian stimulation
  • the wrong kind of ovarian stimulation
  • poor injection techniques
  • obesity

At the root of it, however, a “poor response” to ovarian stimulation is often a consequence of something we call diminished ovarian reserve (DOR) or low functional ovarian reserve.

Ovarian Reserve (OR) is the term used to describe the ability of a woman’s ovaries to produce high-quality eggs. As women age, their OR naturally declines, which is why it is more difficult for older women to get pregnant, even with fertility treatment. But DOR isn’t exclusive to older women. In fact, approximately 10 percent of women suffer from premature ovarian aging (POA), a condition in which their OR begins to decline much earlier in life than average. These women not only have difficulties conceiving naturally, but are often “poor responders” to ovarian stimulation, especially if a “one-size-fits-all” ovarian stimulation is used.

Individualized stimulation protocols can address "poor response"

For women suffering from DOR or POA, the problem is not that they are “poor responders,” but that their unique ovarian environments are not being addressed in their treatment and ovarian stimulation. At CHR, our first step is determining an appropriate diagnosis based on age-specific FSH/AMH levels and antral follicle counts. Once we have a better idea of our patient’s ovarian environment and ovarian reserve, we develop an individualized treatment plan that specifically addresses the cause of her “poor response.”

Learn more about how CHR can help you (POA/DOR Patient) overcome your “poor responder” status by scheduling a consultation. We are here for you. 

Author
Norbert Gleicher, MD, FACOG, FACS Norbert Gleicher, MD, FACOG, FACS, is an infertility specialist specializing in autoimmune diseases at the Center for Human Reproduction in the Upper East Side of Manhattan in New York City.

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