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The evaluation and treatment of low responders in assisted reproductive technology (ART) remains a challenge. Poor responders have a higher incidence of cycle cancellation, lower fertilization, and lower pregnancy and implantation rates. Static tests for the prediction of poor responders include day 3 measurement of the concentration of serum follicle- stimulating hormone (FSH), serum inhibin B, serum estradiol (E2), and serum anti-Mullerian hormone (AMH) as well as the determination of the antral follicle count (AFC), the ovarian volume (OVVOL), and the ovarian blood flow. Dynamic tests assess the response of the ovary to a defined dose of an ovarian stimulation agent. They include the clomiphene citrate (CC) challenge test, the FSH stimulation test, as well as the gonadotrophin agonist stimulation test. Various adjuvant therapies have been suggested for improving the results of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in poor responders.
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