Microdose gonadotropin-releasing hormone agonist flare-up protocol versus multiple dose gonadotropin-releasing hormone antagonist protocol in poor responders undergoing intracytoplasmic sperm injection–embryo transfer cycle

Kahraman, Korhan; Berker, Bülent; Atabekoğlu, Cem Somer; Sönmezer, Murat; Çetinkaya, Şerife Esra; Aytaç, Ruşen; Şatıroğlu, Hakan

doi:10.1016/j.fertnstert.2008.03.057

Cited by 65 publications

(51 citation statements)

References 28 publications

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“…In spite of significant advances in assisted reproductive techniques (ART), the management of poor-responding patients is still intricate [2]. A poor ovarian response to controlled ovarian hyper stimulation (COH) occurs in 9-24 % of women undergoing IVF [1,3,4].…”

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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“…Other potential benefits include the lower risk of ovarian hyperstimulation syndrome [15]. However, its influence on IVF outcome and pregnancy rate, in comparison to GnRH-a protocol is controversial [16][17][18][19][20]. It is, therefore, important to understand the impact of regimes used for COH on IVF outcome as it may help physicians in predicting the chance of women becoming pregnant after IVF.…”

Section: Introductionmentioning

confidence: 99%

A comparative study on oxidative and antioxidative markers of serum and follicular fluid in GnRH agonist and antagonist cycles

Çelik

Kumbak

et al. 2012

J Assist Reprod Genet

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Objective To determine whether concentrations of oxidative stress markers of follicular fluid and serum are different in GnRH agonist protocol from GnRH antagonist protocol. Material and method This was a cross-sectional study. Eighty-four women undergoing controlled ovarian stimulation with either GnRH agonist (n039) or GnRH antagonist protocols (n045) for IVF/ICSI treatment were assigned by a physician. Blood was obtained at the time of oocyte retrieval, and follicular fluid (FF) from the mature follicles of each ovary was centrifuged and frozen until analysis. Malondialdehyde (MDA), nitric oxide (NO), protein carbonyl (PC), hydroxyl proline (OH-P), sodium oxide dismutase (SOD), reduced glutathione (GSH), glutathione peroxidase (GSH-Px), adenosine deaminase (ADA) and xanthine oxidase (XO) were assessed in the serum and follicular fluid of each participants. ResultsThe mean serum concentrations of GSH-Px, GSH and MDA were lower in the GnRH antagonist group compared to GnRH agonist group, but mean serum SOD was higher in the GnRH antagonist group. The mean follicular SOD, ADA and NO were higher in GnRH antagonist group than GnRH agonist group. The IVF/ICSI outcomes were similar in both groups. Conclusion(s) GnRH antagonist protocol is associated with increased oxidative stress. The relation of GnRH analogues with oxidative stress and its implication in follicular growth needs to be addressed in further studies.

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“…In contrast, positive β-hCG, clinical pregnancy and live birth rates were low, but similar for both groups studied, as was the miscarriage rate, which appeared to be increased in both regimes. These results might possibly be attributed to the otherwise anticipated low pregnancy rates in this category of patients with compromised ovarian response (16,27,28), added to the observation that a higher dose of gonadotropin does lead to improved implantation rates (29). Regarding clinical pregnancy rates, our findings are in agreement with the existing trials (19)(20)(21); notably, a difference of 8%, favoring the conventional protocol did not manage to reach statistical significance, as one would expect the higher number of COCs to result in such a difference.…”

Section: Discussionmentioning

confidence: 96%

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

Siristatidis

Salamalekis

Dafopoulos

et al. 2017

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Microdose gonadotropin-releasing hormone agonist flare-up protocol versus multiple dose gonadotropin-releasing hormone antagonist protocol in poor responders undergoing intracytoplasmic sperm injection–embryo transfer cycle

Cited by 65 publications

References 28 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

A comparative study on oxidative and antioxidative markers of serum and follicular fluid in GnRH agonist and antagonist cycles

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

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