The sub-optimal response to controlled ovarian stimulation: manageable or inevitable?

In the paper entitled ‘Sub-optimal responders following controlled ovarian stimulation: an overlooked group?’, the authors propose to create a new, presumed clinically relevant, ovarian response category. Today, the poor responder is indisputably recognized as problematic, as the far below average prognosis for live birth, especially in women of higher age, sheds doubt on the added value of assisted reproductive technology (ART). Increasingly, the disadvantages of the high ovarian response become clear, with an uncertain safety profile and a trend towards suboptimal live birth rates. Individualized management of these two patient groups has been the focus of a handful of studies and an ocean of opinions. We are not even close to evidence on how performance of ovarian stimulation will become optimized in terms of effi