卵巢反應不佳之三大指標

卵巢反應不佳之三大指標:
FSH>10
AMH<1
AFC<5

其他指標
Age >40

http://humrep.oxfordjournals.org/content/26/7/1616.full

ESHRE consensus on the definition of ‘poor response' to ovarian stimulation for in vitrofertilization: the Bologna criteria^†

1. A.P. Ferraretti1,*, 
2. A. La Marca2, 
3. B.C.J.M. Fauser3, 
4. B. Tarlatzis4,
5. G. Nargund5, 
6. L. Gianaroli1 and 
7. on behalf of the ESHRE working group on Poor Ovarian Response Definition‡

+Author Affiliations

1. ¹S.I.S.Me.R Reproductive Medicine Unit, Via Mazzini 12, 40138 Bologna, Italy
2. ²Mother-Infant Department, University Hospital Policlinico di Modena, Modena, Italy
3. ³Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht, Utrecht, The Netherlands
4. ⁴Unit for Human Reproduction, Papageorgiou General Hospital, Thessaloniki, Greece
5. ⁵Department of Obstetrics and Gynecology, St George's Hospital, London, UK

1. *↵Correspondence address. Tel: +39-51-307-307; Fax: +39-51-302-933; E-mail:annapia.ferraretti@sismer.it

1. ↵† This manuscript has been approved by the Executive Committee of ESHRE. It has not been externally peer-reviewed.
2. ↵‡ The ESHRE working group on Poor Ovarian Response Definition  is endorsed by the coordinators of all the Special Interest Groups (Andrology, Early Pregnancy, Embryology, Endometriosis and Endometrium, Ethics and Law, Psychology and Counselling, Reproductive Endocrinology, Reproductive Genetics, Reproductive Surgery, Safety and Quality in ART, Stem Cell) and by the Special Task Force on Mild Approaches in ART.

• Received February 24, 2011.
• Revision received February 24, 2011.
• Accepted March 2, 2011.

 

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Abstract

The definition presented here represents the first realistic attempt by the scientific community to standardize the definition of poor ovarian response (POR) in a simple and reproducible manner. POR to ovarian stimulation usually indicates a reduction in follicular response, resulting in a reduced number of retrieved oocytes. It has been recognized that, in order to define the poor response in IVF, at least two of the following three features must be present: (i) advanced maternal age or any other risk factor for POR; (ii) a previous POR; and (iii) an abnormal ovarian reserve test (ORT). Two episodes of POR after maximal stimulation are sufficient to define a patient as poor responder in the absence of advanced maternal age or abnormal ORT. By definition, the term POR refers to the ovarian response, and therefore, one stimulated cycle is considered essential for the diagnosis of POR. However, patients of advanced age with an abnormal ORT may be classified as poor responders since both advanced age and an abnormal ORT may indicate reduced ovarian reserve and act as a surrogate of ovarian stimulation cycle outcome. In this case, the patients should be more properly defined as ‘expected poor responder’. If this definition of POR is uniformly adapted as the ‘minimal' criteria needed to select patients for future clinical trials, more homogeneous populations will be tested for any new protocols. Finally, by reducing bias caused by spurious POR definitions, it will be possible to compare results and to draw reliable conclusions.