GnRH antagonist multiple dose protocol with oral contraceptive pill pretreatment in poor responders undergoing IVF/ICSI.
10.5653/cerm.2011.38.4.228
- Author:
Chung Hoon KIM
1
;
Rae Mi YOU
;
Hyuk Jae KANG
;
Jun Woo AHN
;
Ilkyung JEON
;
Ji Won LEE
;
Sung Hoon KIM
;
Hee Dong CHAE
;
Byung Moon KANG
Author Information
1. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. chnkim@amc.seoul.kr
- Publication Type:Original Article ; In Vitro ; Randomized Controlled Trial
- Keywords:
Gonadotropin-releasing hormone;
Antagonist;
Agonist;
Oral Contraceptives;
Poor Responders;
In vitro fertilization;
Intracytoplasmic sperm injection;
Human
- MeSH:
Contraceptives, Oral;
Embryonic Structures;
Fertilization in Vitro;
Follicle Stimulating Hormone, Human;
Gonadotropin-Releasing Hormone;
Humans;
Oocytes;
Ovulation Induction;
Pregnancy Rate;
Sperm Injections, Intracytoplasmic
- From:Clinical and Experimental Reproductive Medicine
2011;38(4):228-233
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To investigate the effectiveness of GnRH antagonist multiple-dose protocol (MDP) with oral contraceptive pill (OCP) pretreatment in poor responders undergoing IVF/ICSI, compared with GnRH antagonist MDP without OCP pretreatment and GnRH agonist low-dose long protocol (LP). METHODS: A total of 120 poor responders were randomized into three groups according to controlled ovarian stimulation (COS) options; GnRH antagonist MDP after OCP pretreatment (group 1), GnRH antagonist MDP without OCP pretreatment (group 2) or GnRH agonist luteal low-dose LP without OCP pretreatment (group 3). Patients allocated in group 1 were pretreated with OCP for 21days in the cycle preceding COS, and ovarian stimulation using recombinant human FSH (rhFSH) was started 5 days after discontinuation of OCP. RESULTS: There were no differences in patients' characteristics among three groups. Total dose and days of rhFSH used for COS were significantly higher in group 3 than in group 1 or 2. The numbers of mature oocytes, fertilized oocytes and grade I, II embryos were significantly lower in group 2 than in group 1 or 3. There were no significant differences in the clinical pregnancy rate and implantation rate among three groups. CONCLUSION: GnRH antagonist MDP with OCP pretreatment is at least as effective as GnRH agonist low-dose LP in poor responders and can benefit the poor responders by reducing the amount and duration of FSH required for follicular maturation.
