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Study Question: In subfertile women with poor ovarian reserve undergoing IVF does a mild ovarian stimulation strategy lead to comparable ongoing pregnancy rates in comparison to a conventional ovarian stimulation strategy?Summary Answer: A mild ovarian stimulation strategy in women with poor ovarian reserve undergoing IVF leads to similar ongoing pregnancy rates as a conventional ovarian stimulation strategy.What Is Known Already: Women diagnosed with poor ovarian reserve are treated with a conventional ovarian stimulation strategy consisting of high-dose gonadotropins and pituitary downregulation with a long mid-luteal start GnRH-agonist protocol. Previous studies comparing a conventional strategy with a mild ovarian stimulation strategy consisting of low-dose gonadotropins and pituitary downregulation with a GnRH-antagonist have been under powered and their effectiveness is inconclusive.Study Design, Size, Duration: This open label multicenter randomized trial was designed to compare one cycle of a mild ovarian stimulation strategy consisting of low-dose gonadotropins (150 IU FSH) and pituitary downregulation with a GnRH-antagonist to one cycle of a conventional ovarian stimulation strategy consisting of high-dose gonadotropins (450 IU HMG) and pituitary downregulation with a long mid-luteal GnRH-agonist in women of advanced maternal age and/or women with poor ovarian reserve undergoing IVF between May 2011 and April 2014.Participants/materials, Setting, Methods: Couples seeking infertility treatment were eligible if they fulfilled the following inclusion criteria: female age ≥35 years, a raised basal FSH level >10 IU/ml irrespective of age, a low antral follicular count of ≤5 follicles or poor ovarian response or cycle cancellation during a previous IVF cycle irrespective of age. The primary outcome was ongoing pregnancy rate per woman randomized. Analyses were on an intention-to-treat basis. We randomly assigned 195 women to the mild ovarian stimulation strategy and 199 women to the conventional ovarian stimulation strategy.Main Results and the Role Of Chance: Ongoing pregnancy rate was 12.8% (25/195) for mild ovarian stimulation versus 13.6% (27/199) for conventional ovarian stimulation leading to a risk ratio of 0.95 (95% CI: 0.57-1.57), representing an absolute difference of -0.7% (95% CI: -7.4 to 5.9). This 95% CI does not extend below the predefined threshold of 10% for inferiority. The duration of ovarian stimulation was significantly lower in the mild ovarian stimulation strategy than in the conventional ovarian stimulation strategy (mean difference -1.2 days, 95% CI: -1.88 to -0.62). Also, a significantly lower amount of gonadotropins was used in the mild simulation strategy, with a mean difference of 3135 IU (95% CI: -3331 to -2940).Limitations, Reasons For Caution: A limitation of our study was the lack of data concerning the cryopreservation of surplus embryos, so we are not informed on cumulative pregnancy rates. Another limitation is that we were not able to follow up on the ongoing pregnancies in all centers, so we are not informed on live birth rates.Wider Implications Of the Findings: The results are directly applicable in daily clinical practice and may lead to considerable cost savings as high dosages of gonadotropins are not necessary in women with poor ovarian reserve undergoing IVF. A health economic analysis of our data planned to test the hypothesis that mild ovarian stimulation strategy is more cost-effective than the conventional ovarian stimulation strategy is underway.Study Funding/competing Interests: This study was supported by NUFFIC scholarship (the Netherlands) and STDF short-term fellowship (Egypt).Trial Registration Number: NTR2788 (Trialregister.nl).Trial Register Date: 01 March 2011.Date Of First Patient's Enrolment: May 2011. [ABSTRACT FROM AUTHOR]

Introduction: Different societies have different cultures and all activities and behaviors of individuals in society are deeply influenced by cultural and social factors. Reproductive behavior is strongly intertwined with the cultural beliefs and values of the society; so, the necessity of controlling reproductive behavior depends on various cultural elements and all plans, especially family planning programs that are associated with reproductive behavior should be grounded in social and cultural conditions. Several reasons can prove the necessity to increase the population of the Islamic Republic of Iran, which include the role of population in national authority and keeping a high proportion of youth for maintaining knowledge-based economy, etc. The aim of this study was to investigate the socioeconomic factors affecting fertility. The development of country is one of the main goals of economists and social planners. Development has different aspects, and if we only care about a few of them we will have unbalanced and abnormal growth that not only can't lead to development, but can also be an impediment. Materials and Methods: This research used review studies. Library documents and dissertations comprised resources for this article. Results: The rise and decline of population growth and its consequences are one of the most important economic and social issues in any society. Educated women are most commonly employed and fertility may be reduced in outdoors women. They also tend to study more, so they are more familiar with contraception and their fertility rates would be reduced. Thus, providing opportunities for teleworking may change the approach of employed women about pregnancy. The fertility rate is higher in younger women. In other words, age may affect female fertility; therefore, facilities for wedding should be provided for youth. Economic status was another variable whose impact on fertility was examined. It was proved that this variable affects women's fertility rate. Conclusion: We can't plan for the future demographic plans in the country so long as decisions regarding population growth have not been made seriously, since current decisions easily affect many investments in the areas of research and decision making. This indicates the lack of expertise in the decision to increase the population. So far, we have not gathered experts who hold different opinions from various fields so they could discuss and reach a comprehensive consensus. It is one of the weaknesses in demographic plans. [ABSTRACT FROM AUTHOR]