Treatments Options for Poor Ovarian Responders

Despite breakthroughs in fertility treatments, practitioners around the world continue to face difficulties in treating poor ovarian responders.

With a growing number of women belonging to this category, it is critical to develop and execute treatment options to improve pregnancy rates in this population.

As opposed to a natural menstrual cycle, in which one dominant follicle emerges from a group of 10 to 20 follicles committed for that cycle, IVF treatment aims to stimulate the ovaries for multi-follicular development. As a result, more fertile oocytes are available, resulting in more embryos for transfer.

Dr. Hrishikesh Pai, one of the best infertility doctor in India, is a pioneer in fertility treatment. He has a good track record in treating women with poor ovarian responses and helping them conceive.

What does poor ovarian response mean?

Poor ovarian response means a woman, even in her 20s or 30s, has a low possibility of pregnancy through IVF or natural conception. Also, they are more likely to have poor IVF outcomes. For poor responders, the IVF specialist in India uses a unique approach to achieve the desired outcomes.

Why is it a matter of concern?

Women with poor ovarian response do not develop an appropriate reaction to IVF treatment, produce fewer embryos, and thus have a lower IVF success rate as a result of a decrease in the Cumulative Pregnancy Rate. Normally, this indicates:

• Inadequate ovulation causes cycle cancellations

• Several unsuccessful cycles

• Need more cycles to start a family

• It increases the overall cost. 

• Aneuploidy increases, resulting in poor-quality embryos and implant failure.

• Pregnancy chances are drastically reduced.

What are the causes for a poor ovarian response?

Apart from decreased ovarian reserve and advanced age, there are other factors that cause a poor response to ovarian stimulation in younger women. It can occur for various reasons such as:

• Ovarian cystectomy in the past

• Single ovary

• Smoking for a long time

• Autoimmune reaction

• Unexplained infertility

• Undergone radiotherapy and chemotherapy in the past.

• Genetic factors like X chromosomal derangements, premature menopause, and FMR1 pre-mutation are an issue.

Challenges faced by poor ovarian responders

Cycle cancellation is common among women who have unsatisfactory response to IVF stimulation. It causes a lot of frustration as the IVF cycle takes a heavy toll on their mental, physical and financial state.

Treatment cancellation due to low ovarian response has been reported to occur in 12 to 30% of all IVF cycles.

Due to the minimal number of oocytes recovered, these women’s total pregnancy rates are far less than regular responders.

Another issue that arises regularly is the increased risk of miscarriage, even when pregnancy is achieved.

The loss of primordial follicles with age has been associated with a decreased oocyte quantity and quality, a primary cause of the poor ovarian response. Low quality oocyte leads to poor embryo quality, which has an impact on the treatment result.

The reasons listed above all contribute to a decreased live birth rate.

Fortunately, things are changing with the advancement in fertility treatment and the availability of top IVF specialist in India.

Treatments for poor ovarian responders

As the success of IVF greatly depends on the total number of oocytes produced, the fertility specialist will try to improve the follicles. For this, the treatment begins two months before your IVF cycle.

At this stage, the follicles are more likely to respond to treatment. Androgens like DHEA supplements and testosterone are used as part of the pre-treatment strategy. High-dose gonadotropins can also help poor responders.

In the double stimulation treatment, two IVF stimulations are performed in one cycle. It causes follicles from both the follicular and luteal phases to be recruited.

Another method is egg accumulation and embryo pooling. In this, the woman undergoes several IVF cycles and cryopreserve the embryos, and later adequate high-quality embryos are transferred for better results.

Poor ovarian responders are difficult to treat, but with proper assessment and treatment, IVF can be quite successful, especially in younger patients.

You can visit Dr. Hrishikesh Pai, one of the best gynecologist in Mumbai for infertility treatment. With his profound knowledge and vast experience, he will help you conceive and become proud parents.