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What does it mean to have a low ovarian response?

By Silvia Azaña Gutiérrez B.Sc., M.Sc. (embryologist).
Last Update: 01/16/2026

In this video, Silvia Azaña, an embryologist at inviTRA, explains what a low ovarian response means:

Low ovarian response is defined as a low number of mature eggs obtained after the process of ovarian stimulation in an IVF treatment. Nevertheless, specialists do not have a universal consensus for defining a poor response to ovarian stimulation.

According to the Bologna criteria, a low response is considered to be present when at least two of these criteria are clearly met:

- A maternal age over 40 or any other potential risk factor for low response.
- Previous cycle with low response. A cycle is considered to have had a low response if three or fewer oocytes are successfully obtained after following a standard ovarian stimulation protocol.
- Ovarian reserve test that shows a decreased result: antral follicle count that is lower than 5-7, or antimüllerian hormone below 0.5-1.1 ng/mL.

Furthermore, it is also considered that a woman is a low responder when, after undergoing two cycles of ovarian stimulation at maximum doses, two low responses are obtained.

Nevertheless, the later POSEIDON Classification managed to achieve a superior stratification of the female patients, depending on the age (under or over 35 years old) and ovarian reserve (an antral follicle count greater or less than 5 and AMH greater or less than 1.2 ng/mL).

The frequency of a low response to ovarian stimulation during fertility treatments shows variability, but it is estimated that it appears in 9 to 24% of patients. Therefore, it is essential that the fertility treatment, along with the ovarian stimulation protocol, is customized right from the start.

 Silvia Azaña Gutiérrez
Silvia Azaña Gutiérrez
B.Sc., M.Sc.
Embryologist
Graduate in Health Biology from the University of Alcalá and specialized in Clinical Genetics from the same university. Master in Assisted Reproduction by the University of Valencia in collaboration with IVI clinics.
License: 3435-CV
Embryologist. Graduate in Health Biology from the University of Alcalá and specialized in Clinical Genetics from the same university. Master in Assisted Reproduction by the University of Valencia in collaboration with IVI clinics. License: 3435-CV.