Difficult-to-treat women for controlled ovarian hyperstimulation: tips and tricks

Paolo Giovanni Artini, Francesca Papini, María Ruggiero, Giulia Scaravelli, Olga Maria Di Berardino, Giovanna Simi, Vito Cela
In: Expert Review of Endocrinology & Metabolism · 2011 · vol. 6(4) , pp. 617–627 · doi:10.1586/eem.11.43 · W2045003635
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This article outlines strategies for controlled ovarian hyperstimulation in poor responders, polycystic ovary syndrome patients, and endometriosis patients to optimize in vitro fertilization outcomes.

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Abstract

The aim of this article is to clarify the different strategies used to induce controlled ovarian hyperstimulation in some groups of difficult-to-treat patients, namely poor-responder patients, polycystic ovarian patients and endometriosis patients. The success of in vitro fertilization depends on adequate follicle recruitment and the recovery of multiple good-quality oocytes by using controlled ovarian hyperstimulation. This is particularly difficult to achieve in patients with a high incidence of low ovarian response (stage III–IV endometriosis and premature ovarian failure patients) or an excessive ovarian response with a risk of ovarian hyperstimulation syndrome (polycystic ovary syndrome patients). Consequently, special methods are needed in these groups of patients in order to optimize in vitro fertilization results.

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endometriosis

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