A comparison of treatment results of the different treatment protocols in patients with poor ovarian response

Gynecol Endocrinol. 2018 Jun;34(6):524-527. doi: 10.1080/09513590.2017.1416464. Epub 2017 Dec 19.

Abstract

To compare the effect of the different protocols in patients receiving in vitro fertilization treatment due to poor ovarian response. Seventy-seven of the patients included in the study were treated with gonadotropin (450 IU) + GnRH antagonist (group 1), 84 of the patients were treated with gonadotropin (450 IU) + microdose GnRH analog (group 2), and 53 of the patients were treated with clomiphene citrate (100 mg/day) + gonadotropin (300 IU) + GnRH antagonist (Group 3). In assessing total gonadotropin dosage, patients in Group 3 detected significantly less gonadotropin as compared to the other two groups (p < .001). Group 1 were superior to the other two groups with respect to retrieved oocytes, meiosis II oocytes and number of embryos obtained at the end of the treatment. As for the evaluation of clinical pregnancy, although the highest pregnancy rate was in Group 3, this finding was not of statistical significance. Although increasing the dosage of gonadotropins for ovarian hyper stimulation treatment in patients with poor ovarian response is beneficial with respect to retrieved oocytes, meiosis II oocytes and number of embryos, the increased dosage does not provide a statistically significant increase in clinical pregnancy rates.

Keywords: GnRH agonist protocol; GnRH antagonist protocol; Poor responder; clomiphene citrate; poor ovarian response.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Chorionic Gonadotropin / administration & dosage*
  • Clinical Protocols
  • Clomiphene / administration & dosage*
  • Female
  • Fertilization in Vitro / methods*
  • Gonadotropin-Releasing Hormone / administration & dosage
  • Gonadotropin-Releasing Hormone / analogs & derivatives*
  • Gonadotropin-Releasing Hormone / antagonists & inhibitors*
  • Gonadotropins / administration & dosage
  • Hormone Antagonists / administration & dosage*
  • Humans
  • Oocyte Retrieval
  • Ovulation Induction / methods*
  • Pregnancy
  • Pregnancy Rate

Substances

  • Chorionic Gonadotropin
  • Gonadotropins
  • Hormone Antagonists
  • Clomiphene
  • Gonadotropin-Releasing Hormone
  • cetrorelix