'Poor responders' is a term used to describe a subpopulation of IVF patients who do not respond well to ovarian stimulation with gonadotrophins. While there is no standard definition of a poor responder, these patients tend to be of advanced maternal age (≥40 years), have a history of poor ovarian response with conventional stimulation protocols, and/or have low ovarian reserve. Despite the heterogeneity of this patient group, there are characteristics and needs common to many poor responders that can be addressed through a holistic approach. Stimulation during the earlier stages of follicle maturation may help synchronize follicle development for improved response to later gonadotrophin stimulation, and supplementation with dehydroepiandrosterone or human growth hormone may promote early follicle development in poor responders. IVF protocols should be specifically tailored to poor responders to complement the patient's natural cycle. Because poor responders tend to have high levels of stress and anxiety, patients should receive psychological counselling and support, both prior to and during IVF cycles, to ensure optimal outcomes and improve patients' experience. It is important to set realistic expectations with poor responders and their partners to help patients make informed decisions and better manage their distress and anxiety.

The magnetic levitation platform consists of polymethyl methacrylate (PMMA), permanent neodymium magnets and aluminum-coated mirrors. 3-mm-thick PMMA components were cut with a laser cutter. A microchannel is placed between two permanent neodymium magnets (NdFeB) with same poles facing each other (1). We applied magnetic levitation principles to profile and sort cells from TESE samples, as a function of their unique levitation profiles. A tissue biopsy sample is suspended in a paramagnetic medium and introduced to the magnetic levitation platform. Tissue sample is levitated, sorted and flowed along the capillary, until they reached their equilibrium height within the system. Levitation heights were imaged an analyzed by in-house developed image analysis software. RESULTS: We have shown that sperm and RBCs in TESE samples have a uniquely different levitation and density signatures. Thus, sperm cells can be sorted and purified using the magnetic levitation system. CONCLUSIONS: Our preliminary results demonstrate that this simple, inexpensive and easy-to-use technology could revolutionize sperm isolation post TESE/TESA by significantly improving the simplicity, efficiency and yield of usable sperm after for ICSITESE/TESA.