Comparison between Soft and Conventional Antagonist protocols for Estradiol Level and Number of Growing Follicles in Women of Poor Ovarian Response

Abstract

Introduction: Poor ovarian responders (PORs) are defined as the group of infertile women who are characterized by decreased response of the ovaries to stimulation. Recently using soft protocol with low doses of Gn with/without oral compounds like letrozole seems superior to the conventional high doses since it is less cost-effective. Objective: Comparing of soft versus conventional GnRH-antagonist protocol in POR for estradiol level and number of growing follicles. Patients and Methods: This was a prospective randomized controlled trial including eighty infertile POR according to Bologna criteria that were divided into two equal groups and undergoing IVF (In vitro fertilization)/ICSI (Intracytoplasmic sperm injection) antagonist protocols. One group underwent soft protocol by using letrozole 2.5 mg twice daily for 5 days starting from cycle day 2-3 overlapped low-dose Gn 225 IU from cycle day 4-5. Other group received high dose Gn only 450 IU from cycle day 2-3. Results: Basal demographic characteristics and hormones, comparison showed no significant difference. The mean AFC was not significantly different (P > 0.05) between the two groups with the number of the growing follicles at day of starting antagonist and at day of trigger. There is a significant difference in the total units of Gn used. Conclusion: Soft protocol is a good option for POR since obtaining the same ovarian response with less cost.