Management of poor ovarian response: 1. Increase the dose of exogenous Gn: Gradually increasing the dose depending on the patient’s specific situation may improve the response in some patients, but some reports suggest that increasing the dose does not improve the pregnancy rate; 2. Use exogenous Gn early to increase follicle recruitment; 3.
Combination of growth hormone (GH): applied early in follicular recruitment, increase blood GH, increase blood and follicular fluid levels of insulin-like growth factor, which in turn acts synergistically with exogenous Gn to induce granulosa cell differentiation and increase follicle number. 4. short (flare up) regimen: short GnRH-a is given on the second day of menstruation to increase the level of Gn in the body to increase follicle recruitment through early stimulation; 5.
GnRH antagonist regimen: Gn injection on day 3 of the menstrual cycle, applied from day 7-8 of the menstrual cycle or after the dominant follicle diameter >14 mm. Single injection of 3 mg, followed by an additional injection 4 days later, or 0.25 mg/d until HCG day. 6. reduced GnRH-a dose: in patients with normal basal FSH levels and poor response use a 50% conventional GnRH-a dose or a superovulatory regimen without down regulation; 7. oral contraceptive line pretreatment: use of oral contraceptives for pretreatment combined with flare up or GnRH-a reduction regimens can improve ovarian responsiveness and IVF outcomes; 8. adjuvant therapy: give 50- 100 mg of aspirin daily may improve ovarian responsiveness by increasing ovarian and uterine blood supply; 9. In vitro maturation (IVM) of human immature oocytes.