Study criteria for DOR
It is blur to distinguish DOR from poor ovarian responder (POR), that
was given the similar definition in this study The Bologna ESHRE
consensus defines women as “poor ovarian responders” when at least two
of the following three characteristics are present: (i) advanced
maternal age (≥40 years) or any of the risk factors for POR, (ii) a
previous poor ovarian response (≤3 oocytes with a conventional
stimulation protocol), and (iii) an abnormal ovarian reserve test (i.e.,
antral follicular count (AFC) <5–7 follicles or AMH
<0.5–1.1 ng/ml)[3]. Consequently, a
young infertile woman with markers of poor ovarian reserve who has never
undergone ART does not meet the Bologna criteria.
In this study, we define DOR more as a state of poor ovarian reserve,
belonging the POSEIDON group 3 or group 4 population, a state of extreme
poor ovarian function, specifically a: (i) women with ≥40 years old or
any of the risk factors for poor ovarian response and/or (ii) an
abnormal ovarian reserve test: antral follicular count (AFC)
<5–7 follicles or anti-Müllerian hormone (AMH) <1.1
ng/ml)[10].