Pretreatment: Does it improve quantity or quality?

Pretreatment medications/manipulations are offered to patients with poor ovarian response, aiming to prevent the occurrence of a spontaneous luteinizing hormone surge, increase the number of preantral and antral follicles, synchronize follicular development, and increase oocytes' yield and quality, with the consequent improvement in cycle outcome. Although early small human studies were encouraging, interpretation of the studies is compromised by variations in the type, dose, combination and duration of the pretreatment medications. Whether these measures would serve as valuable tools in the armamentarium for treating patients with poor ovarian response requires further, large prospective studies that should validate the specific mode/combination of pretreatment measures and identify, before initiating ovarian stimulation, the specific characteristics of women who might benefit from the specific regimen.