TY - JOUR T1 - Strategies for Pituitary Down-regulation to Optimize IVF/ICSI Outcome in Poor Ovarian Responders T2 - Journal of Reproduction & Infertility JT - Journal of Reproduction & Infertility SP - 124 EP - 131 VL - 13 IS - 3 PY - 2012 SN - 2251-676X L1 - https://www.jri.ir/documents/fullpaper/en/504.pdf L2 - https://www.jri.ir/article/504 UR - https://www.jri.ir/en/currentissue.aspx?id=52 PB - Avicenna Research Institute AU - Badawy, Ahmed AU - Wageah, Alaa AU - EL-Gharib, Mohamed AU - Osman, Ezz Eldin AB - The ovarian stimulation of poor responders still remains a challenging task for clinicians. There are numerous strategies that have been suggested to improve the outcome in poor responders but there is still no one pituitary down-regulation protocol that best suits all women with such condition. Traditional GnRH agonist flare and long luteal phase protocols do not appear to be advantageous. Reduction of GnRH agonist doses, "stop" protocols, and microdose GnRH agonist flare regimes all appear to improve outcomes, although the proportional benefit of one approach over another has not been convincingly established. GnRH antagonists improve outcomes in this patient population, although, in general, pregnancy rates appear to be lower in comparison to microdose GnRH agonist flare regimes. CY - Tehran, Iran KW - ICSI KW - IVF KW - Poor ovarian response LA - English