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ovarian insufficiency

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Chapter 7 - Optimal IVF Protocols for Women over 40 and Low Functional Ovarian Reserve
from Section 5 - Optimal Deployment of ART beyond 40
- By David H. Barad, Norbert Gleicher
Edited by Dimitrios S. Nikolaou, David B. Seifer
Book:

Optimizing the Management of Fertility in Women over 40

Published online:

15 September 2022

Print publication:

06 October 2022, pp 81-97
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Summary

As women age, their response to ovulation induction is progressively diminished due to the continuous depletion of primordial follicles and to changes in the ovarian endocrine/paracrine microenvironment. While many couples faced with the reality of a diagnosis of low functional ovarian reserve may turn to the use of donor gametes to achieve a pregnancy, some still feel the need to try on their own, despite a poor prognosis. For such women careful preparation and hormonal priming in the months prior to beginning an IVF cycle can increase their chance of a successful outcome. Optimal treatment of these patients differs from the usual treatment of women with normal ovarian reserve in every aspect and needs to be highly individualized.