Clinical management of low ovarian response to stimulation for IVF: A systematic review

Human Reproduction Update

Volumn 9, Issue 1, 2003, Pages 61-76

  Tarlatzis, B C ^a   Zepiridis, L ^a   Grimbizis, G ^a   Bontis, J ^a  

^a ARISTOTLE UNIVERSITY OF THESSALONIKI   (Greece)

Author keywords

Clinical managment; IVF; Ovarian reserve; Ovarian Stimulation protocols; Poor ovarian response

Indexed keywords

ARGININE; BUSERELIN; CETRORELIX; CLOMIFENE CITRATE; CORTICOSTEROID DERIVATIVE; DEXAMETHASONE; ESTRADIOL; FOLLITROPIN; FOLLITROPIN DERIVATIVE; GESTAGEN; GONADORELIN; GONADORELIN AGONIST; GONADORELIN ANTAGONIST; GONADOTROPIN; GONADOTROPIN DERIVATIVE; GROWTH HORMONE; GROWTH HORMONE RELEASING FACTOR; INHIBIN B; LEUPRORELIN; NAFARELIN; NITRIC OXIDE DONOR; NITRIC OXIDE SYNTHASE; NORETHISTERONE; ORAL CONTRACEPTIVE AGENT; PLACEBO; PROGESTERONE; PYRIDOSTIGMINE; RECOMBINANT FOLLITROPIN; TRIPTORELIN; UNINDEXED DRUG;

CLINICAL PROTOCOL; CLINICAL TRIAL; CORPUS LUTEUM; DRUG MEGADOSE; FEMALE; FERTILIZATION IN VITRO; HATCHING; HORMONAL REGULATION; HORMONE DETERMINATION; HUMAN; INTRACYTOPLASMIC SPERM INJECTION; OOCYTE; OVARY FOLLICLE; OVARY FUNCTION; OVULATION INDUCTION; PREDICTION; PRIORITY JOURNAL; PROSPECTIVE STUDY; REVIEW; STANDARDIZATION; STIMULUS RESPONSE; ZONA PELLUCIDA;

FEMALE; FERTILIZATION IN VITRO; FOLLICLE STIMULATING HORMONE; GLUCOCORTICOIDS; GONADOTROPINS; HUMANS; LEUPROLIDE; NITRIC OXIDE DONORS; OVARY; OVULATION INDUCTION; PREGNANCY;

EID: 0037222107     PISSN: 13554786     EISSN: None     Source Type: Journal    
DOI: 10.1093/humupd/dmg007     Document Type: Review

References (115)

1. Adashi, E. and Rohan, R. (1993) Intraovarian regulation. Peptidergic signalling systems. Trends Endocrinol. Metab., 3, 243-248.
2. Akman, M.A., Erden, H.F., Tosun, S.B., Bayazit, N., Aksoy, E. and Bahceci, M. (2000) Addition of GnRH antagonist in cycles of poor responders undergoing IVF. Hum. Reprod., 15, 2145-2147.
3. Akman, M.A., Erden, H.F., Tosun, S.B., Bayazit, N., Aksoy, E. and Bahceci, M. (2001) Comparison of agonistic flare-up-protocol and antagonistic multiple dose protocol in ovarian stimulation of poor responders: results of a prospective randomized trial. Hum. Reprod., 16, 868-870.
4. Anteby, E.Y., Hurwitz, A. and Korach, O. (1996) Human follicular NO pathway: relation to follicular size, oestradiol concentration and ovarian blood flow. Hum. Reprod., 11, 1947-1951.
5. Bancsi, L.F., Broekmans, F.J., Eijkemans, M.J., de Jong, F.H., Habbema, J.D. and te Velde, E.R. (2002) Predictors of poor ovarian response in in vitro fertilization: a prospective study comparing basal markers of ovarian reserve. Fertil. Steril., 77, 328-336.
6. Bar-Hava, I., Ferber, A., Ashkenazi, J., Dicker, D., Ben-Rafael, Z. and Orvieto, R. (2000) Natural cycle IVF in women aged over 44 years. Gynecol. Endocrinol., 14, 248-252.
7. Barri, P.N., Martinez, F., Coroleu, B., Patera, N. and Veiga, A. (1998) Managing non-responders. Fertility and Reproductive Medicine. Proceedings of XVI World Congress on Fertility and Sterility, 127-137.
8. Bassil, S., Godin, P.A. and Donnez, J. (1999) Outcome of IVF through natural cycles in poor responders. Hum. Reprod., 14, 1262-1265.
9. Battaglia, C., Salvatori, M., Maxia, N., Petraglia, F., Facchinotti, F. and Volpe, A. (1999) Adjuvant L-arginine treatment for in-vitro fertilization in poor responder patients. Hum. Reprod., 14, 1690-1697.
10. Beckers, N.G.M., Macklon, N.S., Eijkemans, M.J.C. and Fauser, B.C.J.M. (2002) Women with regular menstrual cycles and a poor response to ovarian hyperstimulation for in vitro fertilization exhibit follicular phase characteristics suggestive of ovarian aging. Fertil. Steril., 78, 291-297.
11. Ben Shlomo, L, Adashi, E.Y. and Paync, D.W. (1994) The morphogenic/ cytotoxic and prostaglandin stimulating activities of interleukin-1b in the rat ovary are NO dependent. J. Clin. Invest., 49, 1463-1469.
12. Bider, D., Liversushits, A., Yonish, M., Yemini, Z., Mashiach, S. and Dor, J. (1997) Assisted hatching by zona drilling of human embryos in women of advanced age. Hum. Reprod., 12, 317-320.
13. Biljan, M., Mahutte, N., Dean, N., Hemmings, R., Bissonnette, F. and Tan, S. (1998) Effects of pretreatment with an oral contraceptive on the time required to achieve pituitary suppression with gonadotropin-releasing hormone analogues and on subsequent pregnancy rates. Fertil. Steril., 70, 1063-1069.
14. Brzyski, R., Muasher, S., Droesch, K., Simonetti, S., Jones, G. and Rosenwaks, Z. (1988) Follicular atresia associated with concurrent initiation of gonadotropin releasing hormone agonist and follicle-stimulating hormone for oocytes recruitment. Fertil. Steril., 50, 917-921.
15. Cameron, I.T., O'Shea, F.C., Rolland, J.M., Hughes, E.G., de Krester, D.M. and Jealy, D.L. (1988) Occult ovarian failure: a syndrome of infertility, regular menses, and elevated follicle-stimulating hormone concentrations. J. Clin. Endocrinol. Metab., 67, 1190-1194.
16. Cedrin-Dumerin, I., Bstandig, B., Herve, F., Wolf, J.-P., Uzan, M. and Hugues, J.-N. (2000) A comparative study of high fixed-dose and decremental-dose regimens of gonadotropins in a minidose gonadotropin-releasing hormone agonist flare protocol for poor responders. Fertil. Steril., 73, 1055-1056.
17. Chang, M., Chiang, C., Hsieh, T., Soong, Y. and Hsu K. (1998) Use of the antral follicle count to predict the outcome of assisted reproductive technologies. Fertil. Steril., 69, 505-510.
18. Chong, A., Rafael, R. and Forte, C. (1986) Influence of weight in the induction of ovulation with human menopausal gonadotropin and human chorionic gonadotropin. Fertil. Steril., 46, 599-603.
19. Chung-Hoon, K., Hee-Dong, C. and Yoon-Seok, C. (1999) Pyridostigmine co-treatment for controlled ovarian hyperstimulation in low responders undergoing in vitro fertilization- embryo transfer. Fertil. Steril., 71, 652-657.
20. Cohen, J., Alikani, M., Trowbridge, J. and Rosenwaks, Z. (1992) Inplantation enhancement by selective assisted hatching using zona drilling of human embryos with poor prognosis. Hum. Reprod., 7, 685-691.
21. Craft, I., Gorgy, A., Hill, J., Menon, D. and Podsiadly, B. (1999) Will GnRH antagonists provide new hope for patients considered difficult responders' to GnRH agonist protocols? Hum. Reprod., 14, 2959-2962.
22. Crosignani, P.G., Ragni, G., Lombroso, G.C., Scarduelli, C., de Lauretis, L., Caccamo, A., Dalpra, L., Cavioni, V., Cristiani, C., Wyssling, H. et al. (1989) IVF: induction of ovulation in poor responders. J. Steroid Biochem., 32, 171-173.
23. Daya, S. and Gunby, J. (2002) Recombinant versus urinary follicle stimulating hormone for ovarian stimulation in assisted reproduction cycles (Cochrane Review). In: The Cochrane Library, 1, Oxford: Update Software.
24. Deaton, J., Baugness, P., Huffman, C. and Miller, K. (1996) Pituitary response to early follicular phase minidose gonadotropin releasing hormone agonist (GnRH-a) therapy: evidence for a second flare. J. Assist. Reprod. Genet., 13, 390-394.
25. de Boer, E.J., Tonkelaar, I., te Velde, E.R., Burger, C.W., Klip, H. and van Leeuwen, F.E. (2002) A low number of retrieved oocytes at in vitro fertilization treatment is predictive of early menopause. Fertil. Steril., 77, 978-985.
26. Delitala, G., Tomasi, P. and Virdis, R. (1988) Neuroendocrine regulation of human growth hormone secretion. Diagnostic and clinical applications. J. Endocrinol. Invest., 11, 441-462.
27. De Placido, G., Alviggi, C., Mollo, A., Strina, I., Varricchio, M.T. and Molis, M. (2000) Recombinant follicle stimulating hormone is effective in poor responders to highly purified follicle stimulating hormone. Hum. Reprod., 15, 17-20.
28. de Vet, A., Laven, J.S., de Jong, F.H., Themmen, A.P. and Fauser, B.C. (2002) Anti-mullerian hormone serum levels: a putative marker for ovarian aging. Fertil. Steril., 77, 357-362.
29. Dirnfeld, M., Fruchter, O., Yshai, D., Lissak, A., Ahdut, A. and Abramovici, H. (1999) Cessation of gonadotropin-releasing hormone analogue (GnRH-a) upon down-regulation versus conventional long GnRH-a protocol in poor responders undergoing in vitro fertilization. Fertil. Steril., 72, 406-411.
30. Dor, J., Seidman, D.S., Amudai, E., Bider, D., Levran, D. and Mashiach, S. (1995) Adjuvant growth hormone therapy in poor responders to in-vitro fertilization: a prospective randomized placebo-controlled double-blind study. Hum. Reprod., 10, 40-43.
31. Droesch, K., Muasher, S.J., Brzyski, R.G., Jones, G.S., Simonetti, S., Liu, H.C. and Rosenwaks, Z. (1989) Value of suppression with a gonadotropin-releasing hormone agonist prior to gonadotropin stimulation for in vitro fertilization. Fertil. Steril., 51, 292-297.
32. Engmann, L., Sladkevicius, P., Agrawal, R., Bekir, J.S., Campbell, S. and Tan, S.L. (1999) Value of ovarian stromal blood flow velocity measurement after pituitary suppression in the prediction of ovarian responsiveness and outcome of in vitro fertilization treatment. Fertil. Steril., 71, 22-29.
33. Faber, B.M., Mayer, J., Cox, B., Jones, D., Toner, J.P., Oehninger, S. and Muasher, S.J. (1998) Cessation of gonadotropin-releasing hormone agonist therapy combined with high-dose gonadotropin stimulation yields favorable pregnancy results in low responders. Fertil. Steril., 69, 826-830.
34. Fanchin, R., de Ziegler, D., Oliveness, F., Taiels, J., Dzik, A. and Frydman, R. (1994) Exogenous follicle stimulating hormone ovarian reserve test (EFORT): a simple and reliable screening test for detecting 'poor responders' in in-vitro fertilization. Hum. Reprod., 9, 1607-1611.
35. Feldman, B., Seidman, D.S., Levron, J., Bider, D., Shulman, A., Shine, S. and Dor J. (2001) IVF following natural cycles in poor responders. Gynecol. Endocrinol., 15, 328-334.
36. Feldberg, D., Farhi, J., Ashkenazi, J., Dicker, D., Shalev, J. and Ben-Rafael, Z. (1994) Minidose gonadotropin releasing hormone agonist is the treatment of choice in poor responders with high FSH levels. Fertil. Steril., 62, 343-346.
37. Fridstrom, M., Akerlof, E., Sjoblom, P. and Hillensjo, T. (1997) Serum levels of luteinizing and follicle-stimulating hormones in normal and poor-responding patients undergoing ovarian stimulation with urofollitropin after pituitary down regulation. Gynecol. Endocrinol., 11, 25-28.
38. Garcia, J.E., Jones, G.S., Acosta, A.A. and Wright, G. (1983) HMG/HCG follicular maturation for oocytes aspiration: phase II, 1981. Fertil. Steril., 39, 174-179.
39. Garcia-Velasco, J.A., Isaza, V., Requena, A., Martinez-Salazar, F.J., Landazabal, A., Remohi, J., Pellicer A. and Simon C. (2000) High doses of gonadotrophins combined with stop versus non-stop protocol of GnRH analogue administration in low responder IVF patients: a prospective, randomized, controlled trial. Hum. Reprod., 15, 2292-2296.
40. Geurts, J.W., Van Wijk, R.M., Stolker, R.J. and Groen, C.J. (2001) Efficacy of radio-frequency procedures for the treatment of spinal pain: a systematic review of randomized clinical trials. Reg. Anesth. Pain Med., 26, 394-400.
41. Gonen, Y., Jacobsen, W. and Casper, R. (1990) Gonadotropin suppression with oral contraceptives before in vitro fertilization. Fertil. Steril., 53, 282-287.
42. Gorgy, A. and Taramissi, M. (2001) Defining and predicting the poor responder [letter]. Fertil. Steril., 75, 226-227.
43. Gougeon, A. (1996) Regulation of ovarian follicular development in primates: facts and hypotheses. Endocr. Rev., 17, 121-155.
44. Hernandez, E.R., Hurwitz, A., Vera, A., Pellicer, A., Adashi, E.Y., LeRoith, D. and Roberts, C.T., Jr (1992) Expression of the genes encoding the IGFs and their receptors in the human ovary. J. Clin. Endocrinol. Metab., 74, 419-425.
45. Hofmann, G., Toner, J., Muasher, S. and Jones, G. (1989) High-dose follicle-stimulating hormone (FSH) ovarian stimulation in low-responder patients for in vitro fertilization. J. In Vitro Fertil. Embryo Transfer, 6, 285-289.
46. Howles, C.M., Macnamee, M.C. and Edwards, R.G. (1987) Short term use of an LHRH agonist to treat poor responders entering an IVF programme. Hum. Reprod., 2, 655-656.
47. Howles, C.M., Loumaye, E., Germond, M., Yates, R., Brinsden, P., Healey, D., Bonaventura, L.M. and Strowitski T. (1999) Does growth hormone releasing factor assist follicular development in poor responder patients undergoing ovarian stimulation for IVF? Hum. Reprod., 14, 1939-1943.
48. Hughes, S.M., Huang, Z.H., Morris, I.D., Matson, P.L., Buck, P. and Lieberman, B.A. (1994) A double-blind cross-over controlled study to evaluate the effect of human bio-synthetic growth hormone on ovarian stimulation in previous poor responders to in-vitro fertilization. Hum. Reprod., 9, 13-18.
49. Hugues, J.N., Torresani, T., Herve, F., Martin-Pont, B., Tamboise, A. and Santarelli J. (1991) Interest of growth hormone-releasing hormone administration for improvement of ovarian responsiveness to gonadotropins in poor responder women. Fertil. Steril., 55, 945-951.
50. Ibrahim, Z.H., Matson, P.L., Buck, P. and Lieberman, B.A. (1991) The use of biosynthetic human growth hormone to augment ovulation induction with buserelin acetate/human menopausal gonadotropin in women with a poor ovarian response. Fertil. Steril., 55, 202-204.
51. Jia, N., Kalmijn, J. and Hseuh, A. (1986) Growth hormone enhances FSH induced differentiation of cultured rat granulosa cells. Endocrinology, 118, 1401-1409.
52. Karande, V. and Gleicher N. (1999) A rational approach to the management of low responders in IVF. Hum. Reprod., 14, 1744-1749.
53. Karande, V., Jones, G., Veeck, L. and Muasher, S. (1990) High-dose follicle-stimulating hormone stimulation at the onset of the menstrual cycle does not improve the in vitro fertilization outcome in low-responder patients. Fertil. Steril., 53, 486-489.
54. Karande, V., Morris, R., Rinehart, J., Miller, C., Rao, R. and Gleicher N. (1997) Limited success using the 'flare' protocol in poor responders in cycles with low basal follicle-stimulating hormone levels during in vitro fertilization. Fertil. Steril., 67, 900-903.
55. Katayama, K., Roesler, M., Gunnarson, G., Stehlik, E. and Jagusch, S. (1988) Short term use of gonadotropin-releasing hormone agonist (leuprolide) for in vitro fertilization. J. In Vitro Fertil. Embryo Transfer, 5, 332-337.
56. Keay, S.D., Liversedge, N.H., Mathur, R.S. and Jenkins, J.M. (1997) Assisted conception following poor ovarian response to gonadotrophin stimulation. Br. J. Obstet. Gynaecol., 104, 521-527.
57. Keay, S.D., Lenton, E.A., Cooke, I.D., Hull, M.G.R. and Jenkins, J.M. (2001) Low-dose dexamethasone augments the ovarian response to exogenous gonadotrophins leading to a reduction in cycle cancellation rate in a standard IVF programme. Hum. Reprod., 16, 1861-1865.
58. Kenigsberg, D., Littman, B.A., Williams, R.F. and Hodgen, G.D. (1984) Medical hypophysectomy II: Variability of ovarian response to gonadotrophin therapy. Fertil. Steril., 42, 116-126.
59. Kotarba, D., Kotarba, J. and Hughes, E. (2002) Growth hormone for in vitro fertilization (Cochrane Review). In: The Cochrane Library, 1, Oxford: Update Software.
60. Kowalik, A., Barmat, L., Damario, M., Liu, H.C., Davis, O. and Rosenwaks, Z. (1998) Ovarian estradiol production in vivo. Inhibitory effect of leuprolide acetate. J. Reprod. Med., 43, 413-417.
61. Land, J., Yarmolinskaya, M., Dumoulin, J. and Evers, J. (1996) High-dose human menopausal gonadotropin stimulation in poor responders does not improve in vitro fertilization outcome. Fertil. Steril., 65, 961-965.
62. Lanzendorf, S.E., Nehchiri, F., Mayer, J.F., Oehninger, S. and Muasher, S.J. (1998) A prospective, randomised, double-blind study for the evaluation of assisted hatching in patients with advanced maternal age. Hum. Reprod., 13, 409-413.
63. Lass, A., Skull J., McVeigh, E., Margara, R. and Winston, R. (1997) Measurement of ovarian volume by transvaginal sonography before ovulation induction with human menopausal gonadotropin for in vitro fertilization can predict poor response. Hum. Reprod., 12, 294-297.
64. Latouche, J., Crumeyrolle-Arias, M., Jordan, D., Kopp, N., Augendre-Ferrante, B., Cedard, L. and Haour, F. (1989) GnRH receptors in human granulosa cells. Anatomical localization and characterization by autoradiographic study. Endocrinology, 125, 1739-1741.
65. Lee, D.W., Grasso, P., Dattatreyamurty, B., Deziel, M.R. and Reichert, L.E., Jr (1993) Purification of a high molecular weight FSH-receptor binding inhibitor, from human follicular fluid. J. Clin. Endocrinol. Metab., 77, 160-168.
66. Leondires, M.P., Escalpes, M., Segars, J.H., Scott, R.T. and Miller, B.T. (1999) Microdose follicular phase gonadotropin-releasing hormone agonists (GnRH-a) compared with luteal phase GnRH-a for ovarian stimulation at in vitro fertilization. Fertil. Steril., 72, 1018-1023.
67. Levy, T., Limor, R., Villa, Y., Eshel, A., Eckstein, N., Vagman, I., Lidor, A. and Ayalon, D. (1993) Another look at co-treatment with growth hormone and human menopausal gonadotrophins in poor ovarian responders. Hum. Reprod., 8, 834-839.
68. Licciardi, F.L., Liu, H.-C. and Rosenwaks, Z. (1995) Day 3 estradiol serum concentrations as prognosticators of stimulation response and pregnancy outcome in patients undergoing in vitro fertilization. Fertil. Steril., 64, 991-994.
69. Lindheim, S., Barad, D., Witt, B., Ditkoff, E. and Sauer, M. (1996) Short-term gonadotrophin suppression with oral contraceptives benefits poor responders prior to controlled ovarian hyperstimulation. J. Assist. Reprod. Genet., 16, 745-747.
70. Magli, M.C., Gianaroli, L., Ferraretti, A.P., Fortini, D., Aicardi, G. and Montanaro, N. (1998) Rescue of implantation potential in embryos with poor prognosis by assisted hatching. Hum. Reprod., 13, 1331-1335.
71. Mansour, R.T., Rhodes, C.A., Aboulghar, M.A., Serour, G.I. and Kamal, A. (2000) Transfer of zona-free embryos improves outcome in poor prognosis patients: a prospective randomized controlled study. Hum. Reprod., 15, 1061-1064.
72. Marcus, S.F., Brisden, P.R., Macnamee, M., Rainsbury, P.A., Elder, K.T. and Edwards, R.G. (1993) Comparative trial between an ultra short and long protocol of LHRH agonist for ovarian stimulation in IVF. Hum. Reprod., 8, 238-243.
73. Martinez, F., Barri, P.N., Coroleu, B., Tur, R., Sorsa-Leslie, T., Harris, W.J., Groome, N.P., Knight, P.G. and Fowler, P.A. (2002) Women with poor response to IVF have lowered circulating gonadotrophin surge-attenuating factor (GnSAF) bioactivity during spontaneous and stimulated cycles. Hum. Reprod., 17, 634-640.
74. Meldrum, D.R., Wisot, A., Yee, B., Garzo, G., Yeo, L. and Hamilton, F. (1998) Assisted hatching reduces the age-related decline in IVF outcome in women younger than age 43 without increasing miscarriage or monozygotic twinning. J. Assist. Reprod. Genet., 15, 418-421.
75. Miell, J.P., Taylor, A.M., Jones, J., Holly, J.M., Gaillard, R.C., Pralong, F.P., Ross, R.J. and Blum, W.F. (1993) The effects of dexamethasone treatment on immunoreactive and bioactive IGFs and IGFBPs in normal male volunteers. J. Endocrinol., 136, 525-533.
76. Moncada, S., Palmer, R.M.J. and Higgs, E.A. (1991) Nitric oxide: physiology, pathophysiology and pharmacology. Pharmacol. Rev., 43, 109-142.
77. Moreno, C., Ruiz, A., Simon, C., Pellicer, A. and Remohi, J. (1998) ICSI as a routine indication in low responder patients. Hum. Reprod., 13, 2126-2129.
78. Mukherjee, T., Copperman, A.B., Lapinski, R., Sandler, B., Bustillo, M. and Grunfeld, L. (1996) An elevated Day-3 FSH:LH ratio in the presence on normal day-3 FSH predicts a poor response to COH. Fertil. Steril., 65, 588-593.
79. Navot, D., Rosenwaks, Z. and Margalioth, E.J. (1987) Prognostic assessment of female fecundity. Lancet, 1, 645-647.
80. Nikolaou, D., Lavery, S., Turner, C., Margara, R. and Trew, G. (2002) Is there a link between an extremely poor response to ovarian hyperstimulation and early ovarian failure? Hum. Reprod., 17, 1106-1111.
81. Oliveinnes, F., Righini, C., Fanchin, R., Torrisi, C., Hazout, A., Glissant, M., Fernandez, H. and Frydman, F. (1996) A protocol using a low dose of gonadotrophin-releasing hormone agonist might be the best protocol for patients with high FSH concentrations on day-3. Hum. Reprod., 11, 1169-1172.
82. Oosterhuis, G.J.E., Vermes, I., Lambalk, C.B., Michgelsen, H.W. and Schoemaker, J. (1998) Insulin like growth factor(IGF)-I and IGF binding protein-3 concentrations in fluid from human stimulated follicles. Hum. Reprod., 13, 285-289.
83. Out, H., Mannaerts, B., Driessen, S. and Bennink, H. (1996) Recombinant follicle stimulating hormone (rFSH; Puregon) in assisted reproduction: more oocytes, more pregnancies. Results from five comparative studies. Hum. Reprod. Update, 2, 162-167.
84. Padilla, S.L., Smith, R.D. and Garcia, J.E. (1991) The Lupron screening test: tailoring the use of leuprolide acetate in ovarian stimulation for in vitro fertilization. Fertil. Steril., 56, 79-83.
85. Padilla, S., Dugan, K., Maruschak, V., Shalika, S. and Smith, R. (1996) Use of the flare-up protocol with high dose follicle stimulating hormone and human menopausal gonadotropins for in vitro fertilization in poor responders. Fertil. Steril., 65, 796-799.
86. Pellicer, A., Ballester, M.J., Serrano, M.D., Mir, A., Serra-Serra, V., Remohi, J. and Bonilla-Musoles, F.M. (1994) Aetiological factors involved in the low response to gonadotrophins in infertile women with normal basal FSH levels. Hum. Reprod., 9, 906-911.
87. Pellicer, A., Ardiles, G., Neuspiller, F., Remohi, J., Simon, C. and Bonilla-Musoles, F. (1998) Evaluation of the ovarian reserve in young low responders with normal basal FSH levels using 3-D ultrasound. Fertil. Steril., 70, 671-675.
88. Pinkas, H., Orvieto, R., Avrech, O.M., Rufas, O., Ferber, A., Ben-Rafael, Z. and Fisch, B. (2000) Gonadotropin stimulation following GnRH-a priming for poor responders in in vitro fertilization-embryo transfer programs. Gynecol. Endocrinol., 14, 11-14.
89. Polak de Fried, E., Blanco, L., Lancuba, S. and Asch, R.H. (1993) Improvement of clinical pregnancy rate and implantation rate in IVF-ET patients by using methylprednisolone. Hum. Reprod., 8, 393-395.
90. Pu-Tsui, W., Kuo-Kuang, L.R., Jin-Tsung, S., Jen-Wan, H., Ming-Huei, L. and Yu-Ming, H. (2002) Cessation of low dose gonadotropin-releasing hormone agonist therapy combined followed by high-dose gonadotropin stimulation yields a favorable ovarian response in poor responders. J. Assist. Reprod. Genet., 19, 1-6.
91. Raga, F., Bonilla-Musoles, F., Casan, E.M. and Bonilla, F. (1999) Recombinant follicle stimulating hormone stimulation in poor responders with normal basal concentrations of follicle stimulating hormone and oestradiol: improved reproductive outcome. Hum. Reprod., 14, 1431-1434.
92. Rombauts, L., Suikkari, A., MacLachlan, V., Trounson, A. and Healy, D. (1998) Recruitment of follicles by recombinant human follicle-stimulating hormone commencing in the luteal phase of the ovarian cycle. Fertil. Steril., 69, 665-669.
93. Sackett, D.L., Haynes, R.B. and Tugwell, P. (1991) Clinical Epidemiology. Boston, Little Brown and Company.
94. Schachter, M., Friedler, S., Raziel, A., Strassburger, D., Bern, O. and Ron-El, R. (2001) Improvement of IVF outcome in poor responders by discontinuation of GnRH analogue during the gonadotropin stimulation phase-a function of improved embryo quality. J. Assist. Reprod. Genet., 18, 197-204.
95. Schoolcraft, W.B., Schlenker, T., Gee, M., Jones, G.S. and Jones, H.W., Jr (1994) Assisted hatching in the treatment of poor prognosis in vitro fertilization candidates. Fertil. Steril., 62, 551-554.
96. Schoolcraft, W., Schlenker, T., Gee, M., Stevens, J. and Wagley, L. (1997) Improved controlled ovarian hyperstimulation in poor responder in vitro fertilization patients with a microdose follicle-stimulating hormone flare, growth hormone protocol. Fertil. Steril., 67, 93-97.
97. Scott, R. and Navot, D. (1994) Enhancement of ovarian responsiveness with microdoses of gonadotropin-releasing hormone agonists during ovulation induction for in vitro fertilization. Fertil. Steril., 61, 880-885.
98. Scott, R.T., Toner, J.P., Muasher, S.J., Oehninger, S., Robinson, S. and Rosenwaks Z. (1989) Follicle-stimulating hormone levels on cycle day 3, are predictive of in vitro fertilization outcome. Fertil. Steril., 51, 651-654.
99. Scott, R., Carey, K., Leland, M. and Navot, D. (1993) Gonadotropin responsiveness to ultra low-dose leuprolide acetate in baboons. Fertil. Steril., 59, 1124-1128.
100. Seifer, D.B., Lambert-Masserlian, B., Hogan, J.W., Gardiner, A.C., Blazar, A.S. and Berk, C.A. (1997) Day 3 serum inhibin-B is predictive of assisted reproductive technologies outcome. Fertil. Steril., 67, 110-114.
101. Serafini, P., Stone, B., Kerin, J., Batzofin, J., Quinn, P. and Marrs, R. (1988) An alternate approach to controlled ovarian hyperstimulation in 'poor responders': pretreatment with a gonadotropin-releasing hormone analog. Fertil. Steril., 49, 90-95.
102. Shaker, A., Yates, R., Flemming, R., Coutts, J. and Jamieson, M. (1992) Absence of effect of adjuvant growth hormone therapy on follicular responses to exogenous gonadotrophins in women: normal and poor responders. Fertil. Steril., 58, 919-923.
103. Shaller, A., Pittrof, R., Zaidi, J., Bekir, J., Kyei-Mensah, A. and Tan, S. (1995) Administration of progestogens to hasten pituitary desensitization after the use of gonadotropin-releasing hormone agonist in in vitro fertilization in a prospective randomized study. Fertil. Steril., 64, 791-795.
104. Smith, M.P., Mathur, R.S., Keay, S.D., Hall, L., Hull, M.G. and Jenkins, J.M. (2000) Periovulatory human oocytes, cumulus cells and ovarian leucocytes express type-I but not type-II 11β-HSD RNA. Fertil. Steril., 73, 825-830.
105. Stein, A., Rufas, O., Amit, S., Avrech, O., Pinkas, H., Ovadia, J. and Fisch, B. (1995) Assisted hatching by partial zona dissection of human pre-embryos in patients with recurrent implantation failure after in vitro fertilization. Fertil. Steril., 63, 838-841.
106. Suikkari, A.M., Seppala, M., McLachlan, V., Healey, D. and Koistinen, R. (1996) Double blind placebo controlled study: human biosynthetic growth hormone for assisted reproductive technology. Fertil. Steril., 65, 800-805.
107. Surrey, E.S., Bower, J.A., Hill, D.M., Ramsey, J. and Surrey, M.W. (1998) Clinical and endocrine effects of a microdose GnRH agonist flare regimen administered to poor responders who are undergoing in vitro fertilization. Fertil. Steril., 69, 419-424.
108. Toner, J., Philput, C., Jones, G. and Muasher, S. (1991) Basal follicle-stimulating hormone level is a better predictor of in vitro fertilization performance than age. Fertil. Steril., 55, 784-791.
109. Toth, T., Awwad, J., Veeck, L., Jones, H. and Muasher, S. (1996) Suppression and flare regimens of gonadotropin-releasing hormone agonist: use in women with different basal gonadotropin values in an in vitro fertilization program. J. Reprod. Med., 41, 321-326.
110. Tucker, M.J., Ingargiola, P.E., Massey, J.B., Morton, P.C., Wiemer, K.E., Wiker, S.R. and Wright, G. (1994) Assisted hatching with or without bovine oviductal epithelial cell co-culture for poor prognosis in-vitro fertilization patients. Hum. Reprod., 9, 1528-1531.
111. Van Hooff, M.H., Alberda, A.T., Huisman, G.J., Zeilmaker, G.H. and Leeremveld, R.A. (1993) Doubling the human menopausal gonadotrophin dose in the course of an in-vitro fertilization treatment cycle in low responders: a randomized study. Hum. Reprod., 8, 369-373.
112. Van Steirteghem, A.C., Nagy, Z., Joris, H., Liu, J., Staessen, C., Smitz, J., Wisanto, A. and Devroey, P. (1993) High fertilization and implantation rates after ICSI. Hum. Reprod., 8, 1061-1066.
113. Von Korff, M. (1994) Studying the natural history of neck pain. Spine, 19, 2041-2046.
114. Weiner, Z., Thaler, I. an Levron, J. (1993) Assessment of ovarian and uterine blood flow by transvaginal colour Doppler in ovarian stimulated women: correlation with the number of follicles and steroid hormone levels. Fertil. Steril., 59, 743-749.
115. Zeleznik, A.J., Schuler, H.M. and Reichter, L.E. (1981) Gonadotrophin binding sites in the rhesus monkey ovary; role of the vasculature in the selective distribution of HCG to the preovulatory follicle. Endocrinology, 109, 356-362.