Difficult-to-treat women for controlled ovarian hyperstimulation: tips and tricks

Abstract

The aim of this article is to clarify the different strategies used to induce controlled ovarian hyperstimulation in some groups of difficult-to-treat patients, namely poor-responder patients, polycystic ovarian patients and endometriosis patients. The success of in vitro fertilization depends on adequate follicle recruitment and the recovery of multiple good-quality oocytes by using controlled ovarian hyperstimulation. This is particularly difficult to achieve in patients with a high incidence of low ovarian response (stage III–IV endometriosis and premature ovarian failure patients) or an excessive ovarian response with a risk of ovarian hyperstimulation syndrome (polycystic ovary syndrome patients). Consequently, special methods are needed in these groups of patients in order to optimize in vitro fertilization results.

Keywords::

• controlled ovarian hyperstimulation
• endometriosis
• in vitro fertilization
• polycystic ovary syndrome
• poor responder

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.