GnRH Antagonist/Letrozole Versus Microdose GnRH Agonist Flare Protocol in Poor Responders Undergoing In Vitro Fertilization

Abstract

The addition of letrozole to the GnRH antagonist for poor responders does not improve the outcome of assisted reproductive technology cycles. The MF protocol remains the most appropriate protocol in poor responders.

Clinical application of dehydroepiandrosterone in reproduction: A review of the evidence

“…11 These poor responders have poor IVF outcomes with extremely low pregnancy rates (2e4%), in spite of the use of various stimulation protocols and downregulation strategies. 12 The investigation by Casson et al 13 might be the first to utilize DHEA in the assisted reproductive techniques mediated by augmenting ovarian response. Several years later, Barad and Gleicher 14 described an astonishing case with rapidly increased oocyte production after DHEA supplementation.…”

Mild Versus Conventional Ovarian Stimulation for Poor Responders Undergoing IVF/ICSI

“…Clomiphene citrate (18)(19)(20)(21) and letrozole (22)(23)(24)(25)(26) are the two most common pharmaceutical compounds administered for mild ovarian stimulation in poor responders. Nine trials have been published to date utilizing either drug in a mild regime but with varying inclusion criteria in the context of poor ovarian response, thus a differing definition of poor responders complicates an attempted direct comparison of the studies (18)(19)(20)(21)(22)(23)(24)(25)(26).…”

“…Nine trials have been published to date utilizing either drug in a mild regime but with varying inclusion criteria in the context of poor ovarian response, thus a differing definition of poor responders complicates an attempted direct comparison of the studies (18)(19)(20)(21)(22)(23)(24)(25)(26). For the purpose of this study, we provide a comparison of our findings with the published data on previous studies using clomiphene citrate (18)(19)(20)(21) as the different action cascade of the chemical compounds in letrozole, for example, could have potentially affected the investigated outcomes.…”

Letrozole in ovulation induction (a review)

“…По этой тематике было проведено 7 рандомизи-рованных контролируемых исследований с исполь-зованием летрозола в циклах овариальной стимуля-ции у пациенток, проходящих процедуры IVF или ICSI [36][37][38][39][40][41][42]. В 2 исследованиях [36,37] использова-ли летрозол у пациенток с нормальным овариальным ответом, проходящих процедуры IVF/ICSI.…”

“…В 5 рандомизированных исследованиях оценива-лось действие летрозола у 265 пациенток с низким овариальным ответом [38][39][40][41][42]. Пациентки были раз-делены на две группы: в одной группе пациентки по-лучали летрозол совместно с гонадотропинами, в другой -только гонадотропины в протоколах с ис-пользованием агонистов или антагонистов ГнРГ.…”