Diminished Ovarian Reserve and Assisted Reproductive Technologies

Orhan Bukulmez, MD, Associate Professor and Division Director, Division of Reproductive Endocrinology and Infertility; Practice and Medical Director, Fertility and Advanced Reproductive Medicine Assisted Reproductive Technology Program; Medical Director, UT Southwestern Fertility Clinic; Chief, Gynecologic Endocrinology Service, Parkland Health and Hospital System; Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA

Part I: The paradigm of diminished ovarian reserve, conventional & adjuvant treatment approaches for assisted reproductive technologies. 1. Introduction: The Scope of the Problem of Diminished Ovarian Reserve.- 2. Ovarian and Hypothalamic Aging.- 3. Natural History of Diminished Ovarian Reserve.-  4. Definitions and Relevance: Diminished Ovarian Reserve, Poor Ovarian Response, Advanced Reproductive Age, Premature Ovarian Insufficiency.- 5. Food Supplements and Hormonal Products to Improve Assisted Reproductive Technology Outcomes in Diminished Ovarian Reserve Patients.- 6. Traditional Chinese Medicine for Assisted Reproductive Technology.- 7. Controlled Ovarian Stimulation Protocols for IVF: From First IVF baby in the United States and Beyond.- 8. Conventional Controlled Ovarian Stimulation Protocols for Diminished Ovarian Reserve Patients and Poor Responders.- 9. Natural Cycle Approaches for ART.- Part II: Minimal and Mild Stimulation Protocols.- 10. The International Society forMild Approaches in Assisted Reproduction (ISMAAR) Definitions for Mild Stimulation and Their Rationale for Assisted Reproductive Technologies.- 11. Current Outlook of Minimal and Mild Stimulation Protocols for Assisted Reproductive Technologies in Women with Diminished Ovarian Reserve and/or Advanced Reproductive Age.- 12. Minimal Stimulation Protocol for Assisted Reproductive Technologies in Women with Diminished Ovarian Reserve and/or Advanced Reproductive Age.- 13. Mild Stimulation Alternatives to Minimal Stimulation.- 14. Control of Luteinizing Hormone (LH).- 15. Preventing Premature Ovulation.- 16. Trigger Agents and Post-trigger Testing.- 17. Oocyte retrieval.- 18. Fertilization: Conventional IVF versus ICSI.- 19. Embryo Culture: Cleavage versus Blastocyst Stage.- 20. Endometrial Considerations for Minimal Stimulation.- 21. Frozen Embryo Transfer Preparation.- 22. Minimal and Mild Stimulation IVF Results.- Part III: Utilization of Contemporary Technologies in Diminished OvarianReserve Patients.-  23. Fresh versus Frozen Embryo Transfer.- 24. Comprehensive Chromosome Analysis in Diminished Ovarian Reserve Patients.- Part IV: Future Prospects.- 25. Artificial Oocyte and Artificial Ovary Development.-  26. Activation of Ovarian Cortex.- 27. Oocyte Freezing at an Earlier Age.- 28. Ovarian Cortical Tissue Biopsy for Freezing and Auto Transplantation.