Stimulation of the young poor responder: comparison of the luteal estradiol/gonadotropin-releasing hormone antagonist priming protocol versus oral contraceptive microdose leuprolide  

Oleh:

Shastri, Shefali M. ; Barbieri, Elizabeth ; Kligman, Isaac ; Schoyer, Katherine D. ; Davis, Owen K. ; Rosenwaks, Zev

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Fertility and Sterility (keterangan: ada di ClinicalKey) vol. 95 no. 02 (Feb. 2011), page 592-595 .
Topik: FERTILITY; Estrogen priming; IVF failure; GnRH antagonist; poor responder

Ketersediaan

Perpustakaan FK Nomor Panggil: F02.K.2011.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Objective To evaluate in vitro fertilization (IVF) cycle outcomes in young poor responders treated with a luteal estradiol/gonadotropin-releasing hormone antagonist (E2/ANT) protocol versus an oral contraceptive pill microdose leuprolide protocol (OCP-MDL). Design Retrospective cohort. Setting Academic practice. Patient(s) Poor responders: 186 women, aged <35 years undergoing IVF with either E2/ANT or OCP-MDL protocols. Intervention(s) None. Main Outcome Measure(s) Clinical pregnancies, oocytes retrieved, cancellation rate. Result(s) Patients in the E2/ANT group had a greater gonadotropin requirement (71.9 ± 22.2 vs. 57.6 ± 25.7) and lower E2 level (1,178.6 ± 668 vs. 1,627 ± 889), yet achieved similar numbers of oocytes retrieved and fertilized, and a greater number of embryos transferred (2.3 ± 0.9 vs. 2.0 ± 1.1) with a better mean grade (2.14 ± .06 vs. 2.7 ± 1.8) compared with the OCP/MDL group. The E2/ANT group exhibited a trend toward improved implantation rates (30.5% vs. 21.1%) and ongoing pregnancy rates per started cycle: 44 out of 117 (37%) versus 17 out of 69 (25%). Conclusion(s) Poor responders aged <35 years may be treated with the aggressive E2/ANT protocol to improve cycle outcomes. Both protocols remain viable options for this group. Adequately powered, randomized clinical comparison appears justified.

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