“Poor responder” is a term that may be used to describe a person whose ovaries and body do not respond to fertility medications. They typically require higher doses of stimulation medications to produce 4 or less than the optimal number of eggs needed for IVF treatment. This usually means that they will have a lower chance of pregnancy in that IVF cycle.
Diagnosis
A poor responder diagnosis is usually discovered after an IVF cycle that results in a poor stimulation outcome. Ovarian reserve testing can be performed to identify potential issues ahead of time, with a fertility specialist checking the FSH levels and conducting a clomiphene challenge test. The clomiphene challenge test is usually conducted if a woman’s FSH level is 10-15 mIU/mL or the estradiol level is greater than 65 pg/mL. An ultrasound assessment can also help predict resting and antral follicle numbers. Cycle day 3 blood testing of the Inhibin B levels can help determine poor responders as well.
Causes
There are many reasons that a woman could be a poor responder to infertility treatment. Possibilities may include obesity, the wrong type of ovarian stimulation, poor injection techniques, and too little ovarian stimulation. Being a poor responder often comes as a result of diminished ovarian reserve (DOR), or low functional ovarian reserve.
Treatment
Women who are diagnosed as poor responders should discuss whether they fall in the spectrum with their fertility specialist. A few different treatments for poor response to ovarian stimulation may include:
- Modifying stimulation cycle medications, such as different types and amounts of gonadotropins
- Altering the pituitary down regulation protocols
- Advanced laboratory techniques, such as assisted hatching, continuing egg retrieval despite low follicle numbers, or day 2 transfers
- Adjuvant therapy, such as growth hormone or androgen pretreatment
NCCRM
The North Carolina Center for Reproductive Medicine/Talbert Fertility Institute is the premiere center for reproductive health in North Carolina and the East Coast. Our team specializes in fertility testing, diagnosis, and treatment of infertility conditions. We’re experts in IVF, Tubal Ligation Reversal, Male Infertility, Intrauterine Insemination (IUI), Gestation Surrogacy, Family Balancing, and more. Contact us today.
