Pituitary suppression protocol among Bologna poor responders undergoing ovarian stimulation using corifollitropin alfa: does it play any role?

Errázuriz, Joaquín; Drakopoulos, Panagiotis; Pening, David; Racca, A.; Romito, Alessia; Munck, N De; Tournaye, Herman; Vos, M. De; Blockeel, Christophe

doi:10.1016/j.rbmo.2018.12.030

Cited by 9 publications

(6 citation statements)

References 39 publications

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“…They concluded that the agonist protocol was more effective than the antagonist protocol for young POR patients (26). However, other recent studies found no difference in cumulative LBR in POR patients according to the Bologna criteria, irrespective of the type of pituitary suppression by GnRH agonists or antagonists (30,31).…”

Section: Gnrh Analoguesmentioning

confidence: 95%

What Is the Best Regimen for Ovarian Stimulation of Poor Responders in ART/IVF?

Blumenfeld

2020

Front. Endocrinol.

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The infertile patients with aging ovaries-also sometimes referred to as impending premature ovarian insufficiency (POI), impending premature ovarian failure (POF), or poor ovarian responders (POR), constitute a significant and increasing bulk of the patients appealing to IVF/ART. Different causes have been cited in the literature, among the identified etiologies, including chromosomal and genetic etiology, metabolic, enzymatic, iatrogenic, toxic, autoimmune, and infectious causes. Although the most successful and ultimate treatment of POI/POF/POR patients is egg donation (ED), many, if not most, of these infertile women are reluctant to consent to ED upon the initial diagnostic interview, requesting alternative solutions despite the low odds for success. Despite anecdotal case reports, no unequivocal treatment proved to be successful for these patients in prospective randomized controlled trials. Nevertheless, the addition of growth hormone (GH) to ovarian stimulation in POR with GH deficiency may improve the results of controlled ovarian hyperstimulation (COH) and the IVF success. In patients with autoimmune etiology for POR/POI, the combination of glucocorticosteroids, pituitary-ovarian suppression, and COH may be successful in achieving the desired conception.

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Section: Gnrh Analoguesmentioning

confidence: 95%

What Is the Best Regimen for Ovarian Stimulation of Poor Responders in ART/IVF?

Blumenfeld

2020

Front. Endocrinol.

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“…Finally, the heterogeneity encountered in BC POR could explain (a) the fact that none of treatment modalities has been shown to be effective 8 , 21 – 24 and (b) the reluctance of fertility experts to use the BC in POR studies. 14 …”

Section: Bologna Criteriamentioning

confidence: 99%

Update on the management of poor ovarian response in IVF: the shift from Bologna criteria to the Poseidon concept

Drakopoulos

Bardhi

Boudry

et al. 2020

Clin Med�Insights�Reprod�Health

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Despite the considerate progress to which assisted reproduction technology (ART) has been subject since 1978, some issues remain unresolved. Notably, the clinical management of patients with a poor ovarian response is still a challenge in everyday practice, frustrating to both the patient and the fertility expert. Poor ovarian responders (PORs) embody 9–24% of patients undergoing ovarian stimulation, meaning that up to one in four patients conceals a poor reproductive prognosis. The last decade has witnessed the attempts of the medical community to standardize diagnosis of POR with the developing of the Bologna Criteria and the subsequent evolution of the low prognosis patient elaborated in the POSEIDON classification. The aim of this article is to summarize all evidence concerning etiology and management of poor ovarian response, including the most recent advances and future prospects in this regard.

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“…There have been numerous trials done for management of POR using different protocols, but these efforts have not been successful in identifying the exact protocol, which is most effective (4) . The heterogeneity of this group of women may be the reason behind the difficulty in identifying the most effective strategies in management of POR (5) . In 2011, the European Society of Human Reproduction and Embryology (ESHRE) developed the Bologna criteria with the intention of standardizing the description of POR.…”

Section: Introductionmentioning

confidence: 99%

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

Alwan¹,

Al-Obaid²,

Al-Anbari³

2022

The Egyptian Journal of Hospital Medicine

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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.

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Pituitary suppression protocol among Bologna poor responders undergoing ovarian stimulation using corifollitropin alfa: does it play any role?

Abstract: He is currently training at CRG, UZ Brussel, and his clinical and research interests are ovarian stimulation and reproductive endocrinology.

Cited by 9 publications

References 39 publications

What Is the Best Regimen for Ovarian Stimulation of Poor Responders in ART/IVF?

What Is the Best Regimen for Ovarian Stimulation of Poor Responders in ART/IVF?

Update on the management of poor ovarian response in IVF: the shift from Bologna criteria to the Poseidon concept

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

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