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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.
Clomiphene ; Embryonic Structures ; Estrogens ; Gonadotropin-Releasing Hormone* ; Humans ; Pregnancy Rate ; Progesterone ; Superovulation

1.Combined intrauterine and intraligamentary full term pregnancy after in vitro fertilization & embryo transfer.

2.A study of endogenous gonadotropin suppression with oral contraceptives and triggering follicular maturation with GnRH-a before in vitro fertilization.

3.The treatment of unruptured tubal pregnancy with intra-amniotic methotrexate injection under transcaginal sono-guidance.

4.A study of low dose purified follicle-stimulating hormone supplemented with gonadotropin releasing hormone agonist in women with polycystic ovarian disease.

5.The study on successful therapy with electroejaculation and in vitro fertilization-embryo trnasfer.

6.A Study of Surgical Outcome for Multiple Intracranial Aneurysms.

7.A study on psychological strain IVF.

8.Diagnostric Significance of Subxiphoid Two-Dimensional Echocardiography in Congenital Heart Desease of Chlidred.

9.A Study on the Factors Associted with Risk of Bleeding from Intraacranial arteriovenous Malformations.

10.The Effectiveness of Lowdose Gonadotropin-Releasing Hormone Agonist and high dose hMG after Estrogen-Progesterone therapy in poor responder group to ovarian hyperstimulation.

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