Improved controlled ovarian hyperstimulation in poor responder in vitro fertilization patients with a microdose follicle-stimulating hormone flare, growth hormone protocol

Schoolcraft, William B.; Schlenker, Terry; Gee, Marsha; Stevens, John; Wagley, Lyla M.

doi:10.1016/s0015-0282(97)81862-6

Cited by 170 publications

(101 citation statements)

References 13 publications

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“…A micro dose protocol has the benefit of the initial rise in endogenous gonadotropin and maintains effectiveness in premature luteinizing hormone (LH) surge prevention. Pretreatment with oral contraceptives prevents corpus luteum formation and the following stimulation from exogenous GnRH-a [5].…”

Section: Introductionmentioning

confidence: 99%

A comparative study of luteal estradiol pre-treatment in GnRH antagonist protocols and in micro dose flare protocols for poor-responding patients

Davar

Rahsepar

Rahmani

2012

Arch Gynecol Obstet

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Purpose This study aims to verify if luteal estradiol pretreatment improves IVF/ICSI outcomes in a GnRH antagonist protocol as compared with a micro dose GnRH agonist protocol in poor-responding patients. Methods A total of 116 IVF/ICSI cycles were included in this prospective randomized single blind clinical trial. The selected women were randomly assigned to receive an estradiol pre-treatment in a GnRH antagonist protocol (daily oral Estradiol Valerate 4 mg preceding the IVF cycle from the 21st day until the first day of the next cycle) or in oral contraceptive pill micro dose GnRH agonist protocol. Results The patients in the luteal estradiol protocol required more days of stimulation (10.9 ± 1.6 vs. 10.2 ± 1.8) and a greater gonadotropin requirement (3,247.8 ± 634.6 vs. 2,994.8 ± 611 IU), yet similar numbers of oocytes were retrieved and fertilized. There was no significant difference between the two groups in terms of the implantation rates (9.8 vs. 7.9 %) and the clinical pregnancy rates per transfer (16.3 vs. 15.6 %). Conclusion This study demonstrates that the use of estradiol during a preceding luteal phase in a GnRH antagonist protocol can provide similar IVF outcomes when compared to a micro dose GnRH agonist protocol.

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Section: Introductionmentioning

confidence: 99%

A comparative study of luteal estradiol pre-treatment in GnRH antagonist protocols and in micro dose flare protocols for poor-responding patients

Davar

Rahsepar

Rahmani

2012

Arch Gynecol Obstet

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“…However, definite conclusions regarding the ideal approach for their treatment cannot yet be made, mainly due to the great variability among the studies performed (2). Recently, improved outcome has been reported with the application of the minidose GnRH-agonist flare-up protocol, which takes advantage of the initial pituitary stimulation (3,4). However, the application of GnRH-agonists in low responders, even in small doses and for a limited period, has been questioned as they may cause oversuppression of ovarian function, leading to a prolonged cycle and increased treatment costs, without improving the outcome (5).…”

Section: Ivf Unit Department Of Obstetrics and Gynecology Hebrewmentioning

confidence: 99%

Gonadotropin-Releasing Hormone (GnRH)-Antagonist Versus GnRH-Agonist in Ovarian Stimulation of Poor Responders Undergoing IVF

Fasouliotis

Laufer

Sabbagh-Ehrlich

et al. 2003

J Assist Reprod Genet

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Purpose : The objective of this study was to compare the efficacy of GnRH-antagonists to GnRH-agonists in ovarian stimulation of poor responders undergoing IVF. Methods : Retrospective analysis of our data revealed that 56 patients underwent treatment with a GnRH-agonist according to the flare-up protocol. Patients failing to achieve an ongoing pregnancy (n = 53) were subsequently treated in the next cycle with a GnRH-antagonist according to the multiple-dose protocol. Main outcome measures included the clinical pregnancy and implantation rates. Results : While ovulation induction characteristics and results did not differ between the two protocols, the number of embryos transferred was significantly higher (P = 0.046) in the GnRH-antagonist than in the GnRH-agonist stimulation protocol (2.5 ± 1.6 vs. 2.0 ± 1.4, respectively). The clinical pregnancy and implantation rates per transfer in the GnRH-antagonist group appeared higher than in the GnRH-agonist, but did not differ statistically (26.1 and 10.7 compared with 12.2 and 5.9%, respectively). However, the ongoing pregnancy rate per transfer was statistically significantly higher (P = 0.03) in the GnRH-antagonist than in the GnRH-agonist group (23.9 vs. 7.3%, respectively). Conclusion : Applying GnRH-antagonists to ovarian stimulation protocols may offer new hope for IVF poor responder patients. However, further controlled randomized prospective studies with larger sample sizes are required to establish these results.

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“…To improve the pregnancy rate in poor responders, various approaches have been attempted, but a satisfactory solution has not been reached [26,27]. However, most of the approaches have focused on specific aspects by refining induction protocols in poor responders to increase the number of collected oocytes and the quality of the embryos [28,29]. The purpose of the present study was to improve embryo quality in poor responders using a unique culture method.…”

Section: Introductionmentioning

confidence: 99%

Effect of micro-vibration culture system on embryo development

Hur

Park

Ryu

et al. 2013

J Assist Reprod Genet

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Purpose Micro-vibration culture system was examined to determine the effects on mouse and human embryo development and possible improvement of clinical outcomes in poor responders. Materials and methods The embryonic development rates and cell numbers of blastocysts were compared between a static culture group (n=178) and a micro-vibration culture group (n=181) in mice. The embryonic development rates and clinical results were compared between a static culture group (n=159 cycles) and a micro-vibration culture group (n=166 cycles) in poor responders. A micro-vibrator was set at a frequency of 42 Hz, 5 s/60 min duration for mouse and human embryo development.Results The embryonic development rate was significantly improved in the micro-vibration culture group in mice (p<0.05). The cell numbers of mouse blastocysts were significantly higher in the micro-vibration group than in the static culture group (p<0.05). In the poor responders, the rate of high grade embryos was not significantly improved in the micro-vibration culture group on day 3. However, the optimal embryonic development rate on day 5 was improved in the micro-vibration group, and the total pregnancy rate and implantation rate were significantly higher in the micro-vibration group than in the static culture group (p<0.05). Conclusions Micro-vibration culture methods have a beneficial effect on embryonic development in mouse embryos. In poor responders, the embryo development rate was improved to a limited extent under the micro-vibration culture conditions, but the clinical results were significantly improved.

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Improved controlled ovarian hyperstimulation in poor responder in vitro fertilization patients with a microdose follicle-stimulating hormone flare, growth hormone protocol

Cited by 170 publications

References 13 publications

A comparative study of luteal estradiol pre-treatment in GnRH antagonist protocols and in micro dose flare protocols for poor-responding patients

A comparative study of luteal estradiol pre-treatment in GnRH antagonist protocols and in micro dose flare protocols for poor-responding patients

Gonadotropin-Releasing Hormone (GnRH)-Antagonist Versus GnRH-Agonist in Ovarian Stimulation of Poor Responders Undergoing IVF

Effect of micro-vibration culture system on embryo development

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