OBJECTIVE: To assess the efficacy of three different GnRH agonist (GnRH-a) stimulation regimens to improve ovarian response in poor responders undergoing IVF. DESIGN: Retrospective cohort study. SETTING: Center for Reproductive Health at the University of Cincinnati Medical Center. PATIENT(S): Women diagnosed as poor responders who presented consecutively from January 1999 to January 2004. INTERVENTION(S): Patients underwent three different stimulation regimens during IVF cycles: [1] stop protocol: GnRH-a 500 microg/d administered from the midluteal phase to the start of menses, then gonadotropins from day 2 of cycle, [2] microdose flare: GnRH-a 20 microg administered twice daily with gonadotropins from day 2 to the day of hCG administration, or [3] regular dose flare: gonadotropins beginning with GnRH-a on day 2 at 1 mg/d for 3 days, followed by 250 microg/d until the day of hCG administration. MAIN OUTCOME MEASURE(S): Ovarian response, implantation rates, clinical pregnancy and delivery rates. RESULT(S): Sixty-one IVF cycles were included in the study. None of the comparisons reached statistical significance; however, the microdose group demonstrated a trend toward a higher completed pregnancy rate. CONCLUSION(S): The microdose flare protocol for poor responders demonstrated a trend toward higher delivery rates. A larger prospective study would need to be performed to determine whether this trend leads to a significant finding in this patient population.
OBJECTIVE: To assess the efficacy of three different GnRH agonist (GnRH-a) stimulation regimens to improve ovarian response in poor responders undergoing IVF. DESIGN: Retrospective cohort study. SETTING: Center for Reproductive Health at the University of Cincinnati Medical Center. PATIENT(S): Women diagnosed as poor responders who presented consecutively from January 1999 to January 2004. INTERVENTION(S): Patients underwent three different stimulation regimens during IVF cycles: [1] stop protocol: GnRH-a 500 microg/d administered from the midluteal phase to the start of menses, then gonadotropins from day 2 of cycle, [2] microdose flare: GnRH-a 20 microg administered twice daily with gonadotropins from day 2 to the day of hCG administration, or [3] regular dose flare: gonadotropins beginning with GnRH-a on day 2 at 1 mg/d for 3 days, followed by 250 microg/d until the day of hCG administration. MAIN OUTCOME MEASURE(S): Ovarian response, implantation rates, clinical pregnancy and delivery rates. RESULT(S): Sixty-one IVF cycles were included in the study. None of the comparisons reached statistical significance; however, the microdose group demonstrated a trend toward a higher completed pregnancy rate. CONCLUSION(S): The microdose flare protocol for poor responders demonstrated a trend toward higher delivery rates. A larger prospective study would need to be performed to determine whether this trend leads to a significant finding in this patient population.
Authors: Kate Devine; Sunni L Mumford; Mae Wu; Alan H DeCherney; Micah J Hill; Anthony Propst Journal: Fertil Steril Date: 2015-06-11 Impact factor: 7.329
Authors: Vuk P Jovanovic; Daniel H Kort; Michael M Guarnaccia; Mark V Sauer; Rogerio A Lobo Journal: J Assist Reprod Genet Date: 2011-10-12 Impact factor: 3.412
Authors: Eric D Levens; Brian W Whitcomb; Jonathan D Kort; Donna Materia-Hoover; Frederick W Larsen Journal: Fertil Steril Date: 2008-02-04 Impact factor: 7.329