الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Ovarian reserve is a term that is used to determine the capacity of the ovary to provide eggs that are capable of fertilization resulting in a healthy and successful pregnancy , and is considered normal in conditions where stimulation with the use of exogenous gonadotropins will result in the development of sufficient number of follicles and the retrieval of a corresponding number of healthy oocytes at follicle puncture. Decreased ovarian reserve is the primary cause of decreased chance of spontaneous conception and poor response to ovarian stimulation. There are many factors reducing ovarian reserve as advanced female age, smoking, obesity, endometriosis, surgery, laparoscopic procedures to the ovary, and others. There is no accurate method for assessing ovarian reserve but indirect determination of it is important in treatment of infertility. A number of ovarian tests have been studied for their ability to predict outcome of IVF in terms of oocyte yield and occurrence of pregnancy. Poor ovarian response is not infrequent and represents one of the major therapeutic challenges in IVF. Evidence suggests that it cannot be reliably predicted and even though numerous management options have been explored, a single effective strategy has not yet been established. One of the major limitations of interpreting the relevant literature is the wide variability in the definitions used for poor ovarian response. Ovarian stimulation is a critical step in in vitro fertilization therapy. A variety of controlled ovarian hyperstimulation regimens are available and efficacious, but individualization of management is essential and depends on assessment of the ovarian reserve. Identification of the etiologies of poor ovarian response constitutes the real challenge. Multiple COH strategies have been implemented in this group of challenging patients.This variety of protocols reflects high within-group variability, a probably multifactorial origin but more importantly, an overall compromised outcome.