Protocol for IVF in Women with Decreased Ovarian Reserve or Prior Poor Ovarian Response

The term 'Ovarian Reserve' refers to both the number and the quality of
the eggs remaining in a woman's ovaries. As women age, a decline in
ovarian reserve is manifested as increasing difficulty becoming
pregnant. Modern fertility treatment has given women with decreased
ovarian reserve the possibility of becoming pregnant via IVF. The
challenge in these patients is their ovaries typically don't respond
well to the medications used in IVF. As a result, fewer eggs are
retrieved and the overall chance for pregnancy is diminished.

A major goal in Assisted Reproductive Technology is to improve IVF
outcomes in women with decreased ovarian reserve. To this end,
physicians typically vary the timing and dosages of the medications
utilized during IVF stimulation. These variations are termed protocols.

The objective of this study is to compare ovarian response to two
different IVF medication protocols in women with either decreased
ovarian reserve, or a prior poor response to IVF medications. These
protocols have been designed by the physicians at Seattle Reproductive
Medicine in an effort to improve IVF outcomes in these two groups.

If you participate in this research study you will be randomly assigned
to one of two stimulation protocols and you will receive most of your
medications at no charge. There are no study drugs involved. The
medications you will take are FDA approved, and are used in current IVF
protocols at Seattle Reproductive Medicine. We do not know if one
protocol is better than the other.

You may be eligible for this study if:

• Your provider has recommended ART
• You are 40 years of age or less at the time your cycle is
  started
• Have been diagnosed with decreased ovarian reserve or have had
  a poor response in a prior IVF cycle
• Meet all standard pre -IVF cycle screening measures

If you would like to learn more about this study, please contact your
Seattle Reproductive Medicine nurse or make an appointment to be
evaluated by one of our physicians.

Revised December 23, 2008