ABSTRACT
One of the greatest challenges in clinical reproductive endocrinology is evaluation and management of patients who respond poorly to exogenous gonadotropins and who are categorized as “low responders”. Identifying potential low responders is of critical clinical importance. These patients require specialized management to optimize the number and quality of oocytes that may be available for assisted reproductive technology (ART) procedures. Even with optimal management, their clinical pregnancy and delivery rates are diminished compared with age-matched controls, and patients should be counseled accordingly. This chapter will review how low responders are defined, what screening tests are available to predict diminished gonadotropin response and oocyte quality, and basic treatment protocols that may be used to optimize outcomes for this difficult group of patients.
