The Poor Responders, Definition, Etiology, Management

سال انتشار: 1401
نوع سند: مقاله کنفرانسی
زبان: انگلیسی
مشاهده: 41

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شناسه ملی سند علمی:

RROYAN23_165

تاریخ نمایه سازی: 17 دی 1401

چکیده مقاله:

Different authors have used different criteria to define POR At leas t two of the following three features mus t be present:I. Advanced maternal age (≥۴۰ years), II. A previous POR (≤۳oocytes with a conventional s timulation protocol); III. An abnormalovarian reserve tes t (i.e., AFC ,۵–۷ follicles or AMH,۰.۵–۱.۱ ng/ml).Prevalence: ۱۰--۱۵% of women undergoing IVF have a poorresponse.Etiology:Advanced maternal age, premature ovarian failure, Decreasedovarian reserve due to: Genetics, Surgery, Endometriosis, Radiation,Chemotherapy.Diagnosis:The diagnosis of Poor responders is based on:Female age, clinical evaluation: no of follicles: ۱-۴, no of oocytes:۱-۴, Peak Es tradiol levels: < ۵۰۰ pg/ml, excessive requirementsof gonadotropins: > ۴۵۰ IU.Tes ts: Basal day ۳ FSH, CC challenge tes t, inhibin B, AMH,ovarian and volume, antral follicle count.In the poor responder there are: large doses of s timulation needed,less than optimal number of egg, low oocyte quality, highcancellation rate, low fertilization rate, low embryo number,low embryo quality, low pregnancy rate, low birth rate.The management of poor responders:Conventional treatment:Modified s timulation with: Agonis t protocol, antagonis t, minidose protocol, s top”protocol, short/ultra-short/flare protocol,micro dose flare protocol, natural cycle,Adjuvant therapy: Growth hormone, androgens (Tes tos terone& DHEAS), soft protocols, r-LH, l-arginine, s teroids, aspirin.New treatment: Dous tim protocol, natural and modified naturalprotocol, luteal es tradiol, donor oocyte, PRP and s tem celltherapy.

نویسندگان

M Mashayekhi

Department of Endocrinology and Female Infertility, ReproductiveBiomedicine Research Center, Royan Ins titute for ReproductiveBiomedicine, ACECR, Tehran, Iran