The Effectiveness of Lowdose Gonadotropin-Releasing Hormone Agonist and high dose hMG after Estrogen-Progesterone therapy in poor responder group to ovarian hyperstimulation.
- Author:
Sang Hoon YI
;
Min HUR
;
Yeon hee KIM
;
Dong ho KIM
;
Do hwan BAE
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
IVF;
poor responders;
GnRH-a;
hMG;
E-P therapy
- MeSH:
Clomiphene;
Embryonic Structures;
Estrogens;
Gonadotropin-Releasing Hormone*;
Humans;
Pregnancy Rate;
Progesterone;
Superovulation
- From:Korean Journal of Obstetrics and Gynecology
2000;43(1):76-81
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: To evaluate the efficacy of low dose gonadotropin releasing hormone agonist(GnRH-a) therapy combined with high dose human menopausal gonadotrpin(hMG) following estrogen & progesteron therapy for poor responders. METHODS: From May 1997 to Feb 1999, 36 patients who were defined as poor responders on previous consecutive two and more superovulation cycles were randomly allocated to lowdose GnRH-a short protocol with high dose hMG protocol pretreated with estrogen & progesterone(E/P therapy)(n=16)(study group) and the clomiphene citrate with hMG(n=20)(control group). All patients were planned to undergone in-vitro- fertilization(IVF) and embryo transfer(ET) after controlled ovarian hyperstimulation(COH). RESULTS: Two groups were similar with respect to clinical features and basal FSH and E2 levels. The mean level of E2 on day 5, 304.3+/-148.ng/ml in study group was significantly higher than that in control group, 182+/-34.9ng/ml. The mean levels of E2 on hCG day was also significantly higher in study group than control group(1324+/-320ng/ml, vs 414+/-168ng/ml). The mean day of hCG day in study group, 12.3+/-0.3 was shorter than that in control group, 13.8+/-0.4. The concellation rates of cycles were significantly lower in study group than control group(13.2% vs 84.2%). But clinical pregnancy rates did not showed the significant difference between two groups. CONCLUSION: The study suggested that a lowdose GnRH-a short protocol with high dose hMG pretreated with estrogen & progesterone can improve the ovarian response in poor responder group.
