The Conundrum of Poor Ovarian Response: From Diagnosis to Treatment
Despite recent striking advances in assisted reproductive technology (ART), poor ovarian response (POR) diagnosis and treatment is still considered challenging. Poor responders constitute a heterogeneous cohort with the common denominator of under-responding to controlled ovarian stimulation. Inevit...
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doaj-f5c525782e534fb28cc4b7b9d34ec6ab2020-11-25T02:49:03ZengMDPI AGDiagnostics2075-44182020-09-011068768710.3390/diagnostics10090687The Conundrum of Poor Ovarian Response: From Diagnosis to TreatmentPolina Giannelou0Mara Simopoulou1Sokratis Grigoriadis2Evangelos Makrakis3Adamantia Kontogeorgi4Agni Pantou5Dionysios Galatis6Theodoros Kalampokas7Panagiotis Bakas8Stamatis Bolaris9Konstantinos Pantos10Konstantinos Sfakianoudis11Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, GreeceDepartment of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, GreeceDepartment of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, GreeceThird Department of Obstetrics and Gynecology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, 1, Rimini, 12462 Haidari-Athens, GreeceThird Department of Obstetrics and Gynecology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, 1, Rimini, 12462 Haidari-Athens, GreeceCentre for Human Reproduction, Genesis Athens Clinic, 14–16, Papanikoli, 15232 Athens, GreeceDepartment of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, GreeceSecond Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 76, Vasilisis Sofias Avenue, 11528 Athens, GreeceSecond Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 76, Vasilisis Sofias Avenue, 11528 Athens, GreeceAssisted Conception Unit, General-Maternity District Hospital “Elena Venizelou”, Elenas Venizelou Avenue, 11521 Athens, GreeceCentre for Human Reproduction, Genesis Athens Clinic, 14–16, Papanikoli, 15232 Athens, GreeceCentre for Human Reproduction, Genesis Athens Clinic, 14–16, Papanikoli, 15232 Athens, GreeceDespite recent striking advances in assisted reproductive technology (ART), poor ovarian response (POR) diagnosis and treatment is still considered challenging. Poor responders constitute a heterogeneous cohort with the common denominator of under-responding to controlled ovarian stimulation. Inevitably, respective success rates are significantly compromised. As POR pathophysiology entails the elusive factor of compromised ovarian function, both diagnosis and management fuel an ongoing heated debate depicted in the literature. From the criteria employed for diagnosis to the plethora of strategies and adjuvant therapies proposed, the conundrum of POR still puzzles the practitioner. What is more, novel treatment approaches from stem cell therapy and platelet-rich plasma intra-ovarian infusion to mitochondrial replacement therapy have emerged, albeit not claiming clinical routine status yet. The complex and time sensitive nature of this subgroup of infertile patients indicates the demand for a consensus on a horizontally accepted definition, diagnosis and subsequent effective treating strategy. This critical review analyzes the standing criteria employed in order to diagnose and aptly categorize POR patients, while it proceeds to critically evaluate current and novel strategies regarding their management. Discrepancies in diagnosis and respective implications are discussed, while the existing diversity in management options highlights the need for individualized management.https://www.mdpi.com/2075-4418/10/9/687poor ovarian responsediagnosismanagementBologna criteriaPoseidon groupgonadotropin stimulation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Polina Giannelou Mara Simopoulou Sokratis Grigoriadis Evangelos Makrakis Adamantia Kontogeorgi Agni Pantou Dionysios Galatis Theodoros Kalampokas Panagiotis Bakas Stamatis Bolaris Konstantinos Pantos Konstantinos Sfakianoudis |
spellingShingle |
Polina Giannelou Mara Simopoulou Sokratis Grigoriadis Evangelos Makrakis Adamantia Kontogeorgi Agni Pantou Dionysios Galatis Theodoros Kalampokas Panagiotis Bakas Stamatis Bolaris Konstantinos Pantos Konstantinos Sfakianoudis The Conundrum of Poor Ovarian Response: From Diagnosis to Treatment Diagnostics poor ovarian response diagnosis management Bologna criteria Poseidon group gonadotropin stimulation |
author_facet |
Polina Giannelou Mara Simopoulou Sokratis Grigoriadis Evangelos Makrakis Adamantia Kontogeorgi Agni Pantou Dionysios Galatis Theodoros Kalampokas Panagiotis Bakas Stamatis Bolaris Konstantinos Pantos Konstantinos Sfakianoudis |
author_sort |
Polina Giannelou |
title |
The Conundrum of Poor Ovarian Response: From Diagnosis to Treatment |
title_short |
The Conundrum of Poor Ovarian Response: From Diagnosis to Treatment |
title_full |
The Conundrum of Poor Ovarian Response: From Diagnosis to Treatment |
title_fullStr |
The Conundrum of Poor Ovarian Response: From Diagnosis to Treatment |
title_full_unstemmed |
The Conundrum of Poor Ovarian Response: From Diagnosis to Treatment |
title_sort |
conundrum of poor ovarian response: from diagnosis to treatment |
publisher |
MDPI AG |
series |
Diagnostics |
issn |
2075-4418 |
publishDate |
2020-09-01 |
description |
Despite recent striking advances in assisted reproductive technology (ART), poor ovarian response (POR) diagnosis and treatment is still considered challenging. Poor responders constitute a heterogeneous cohort with the common denominator of under-responding to controlled ovarian stimulation. Inevitably, respective success rates are significantly compromised. As POR pathophysiology entails the elusive factor of compromised ovarian function, both diagnosis and management fuel an ongoing heated debate depicted in the literature. From the criteria employed for diagnosis to the plethora of strategies and adjuvant therapies proposed, the conundrum of POR still puzzles the practitioner. What is more, novel treatment approaches from stem cell therapy and platelet-rich plasma intra-ovarian infusion to mitochondrial replacement therapy have emerged, albeit not claiming clinical routine status yet. The complex and time sensitive nature of this subgroup of infertile patients indicates the demand for a consensus on a horizontally accepted definition, diagnosis and subsequent effective treating strategy. This critical review analyzes the standing criteria employed in order to diagnose and aptly categorize POR patients, while it proceeds to critically evaluate current and novel strategies regarding their management. Discrepancies in diagnosis and respective implications are discussed, while the existing diversity in management options highlights the need for individualized management. |
topic |
poor ovarian response diagnosis management Bologna criteria Poseidon group gonadotropin stimulation |
url |
https://www.mdpi.com/2075-4418/10/9/687 |
work_keys_str_mv |
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