Received December 02, 2013
Accepted July 30, 2013

In general, patients with low ovarian reserve are difficult to manage and have a relatively poor prognosis. Using traditional stimulation protocols like the long GnRH agonist protocol or the GnRH antagonist protocol in these patients often results in low ovarian response and poor pregnancy rates. In natural menstrual cycles without ovarian stimulation, every month the female body naturally selects the best possible oocyte for ovulation. Nevertheless, hormonal changes due to ovarian insufficiency can influence and change the individual menstrual cycle pattern of each patient over the time, which may result in difficulties to conceive naturally. We observed the menstrual cycle pattern of patients with low ovarian reserve in order to distinguish different stages of ovarian insufficiency. Once we were able to describe the different stages, we developed new treatment approaches for each patient group based on Natural Cycle IVF.