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Paper Information

Journal:   INTERNATIONAL JOURNAL OF REPRODUCTIVE BIOMEDICINE (IRANIAN JOURNAL OF REPRODUCTIVE MEDICINE)   April 2018 , Volume 16 , Number 4; Page(s) 255 To 260.
 
Paper: 

Pregnancy outcome in delayed start antagonist versus microdose flare GnRH agonist protocol in poor responders undergoing IVF/ICSI: An RCT

 
 
Author(s):  DAVAR ROBAB, NEGHAB NOSRAT*
 
* Research and Clinical Center for Infertility, Bouali Ave., Safaeyeh, Yazd, Iran, Postal code: 8916877391
 
Abstract: 
Background: Over the years, many article on different aspects of pathogenesis and management of poor ovarian responders have been published but there is no clear guideline for treating themyet. Objective: This study was designated to compare the effectiveness of a delayed start protocol with gonadotropin-releasing hormone (GnRH) antagonist and microdose flare-up GnRH agonist protocol in poor ovarian responders. Materials and Methods: This randomized clinical trial consisted of 100 poor ovarian responder women in assisted reproductive technologies cycles. They were divided randomly in delayed-start antagonist protocol (with estrogen priming followed by early follicular-phase GnRH antagonist treatment for 7 days before ovarian stimulation) and microdose flare-up GnRH agonist protocol. The main outcome was clinical pregnancy rate and second outcome was the number of retrieved oocytes, mature oocytes, 2PN number, fertilization rate, and implantation rate. Results: Fertilization rate, clinical pregnancy rate, and ongoing pregnancy rates were not significantly different between the two studied protocols. Number of retrieved oocytes (5. 10± 3. 41 vs. 3. 08± 2. 51) with p=0. 002, mature oocytes (4. 32± 2. 69 vs. 2. 34± 1. 80) with p=0. 003, number of 2PN (3. 94± 1. 80 vs. 2. 20± 1. 01) with p=0. 001 and implantation rate (19. 40% vs. 10. 30%) with p=0. 022 were significantly higher in delayed antagonist group. Conclusion: The delayed-start protocol can improve ovarian response in poor responders by stimulating and synchronizing follicle development.
 
Keyword(s): Infertility,Assisted reproductive technology,Gonadotropins
 
References: 
 
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