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Reprod Biomed Online. 2015 Jun;30(6):581-92. doi: 10.1016/j.rbmo.2015.03.002. Epub 2015 Mar 16.

How to define, diagnose and treat poor responders? Responses from a worldwide survey of IVF clinics.

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Yale University Fertility Center, New Haven, Connecticut, USA. Electronic address:
Centre for Reproductive Medicine, Vrije University Brussels, Belgium.
Department of Gynecology, Division of Gynecology and Reproductive Medicine, Humanitas Research Hospital Fertility Center, Rozzano, Milan 20084, Italy.
Department of Gynecology and Obstetrics, Division of Reproductive Endocrinology and Infertility, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
The Women's Clinic, Hong Kong.
Department of Obstetrics and Gynaecology, Kaplan Medical Center, Rehovot, Israel; Hadassah Medical School, Jerusalem, Israel.


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, 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.


IVF; decreased ovarian function; management; ovarian stimulation; poor responder; survey

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