Stimulation of the young poor responder: comparison of the luteal estradiol/gonadotropin-releasing hormone antagonist priming protocol versus oral contraceptive microdose leuprolide

Shastri, S.M.; Barbieri, Elizabeth; Kligman, Isaac; Schoyer, Kate D.; Davis, Owen K.; Rosenwaks, Zev

doi:10.1016/j.fertnstert.2010.10.003

Cited by 35 publications

(25 citation statements)

References 18 publications

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“…However, the number of oocytes retrieved and fertilized was similar in the two groups. The E2/antagonist group showed to be tending toward improved implantation rates and ongoing pregnancy rates per started cycle [17].…”

Section: Discussionmentioning

confidence: 94%

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: Discussionmentioning

confidence: 94%

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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“…Because with preconditions, such as PCOS, POF, and autoimmune diseases, can affect oocyte quality and thus the fertilization rate, we excluded these patients from our study [Kilic et al 2008;Zhang et al 2013]. The patients undergoing treatment with hormones within three months of the study were also excluded [Shastri et al 2011], as the effects of hormones on outcomes measured in this study remain controversial [Decanter et al 2013]. The fertilization rate was a function of the rate of mature oocytes.…”

Section: Resultsmentioning

confidence: 99%

Comparison of fertilization outcome between microdrop and open insemination methods in non-male factor IVF patients

Mai

et al. 2014

Systems Biology in Reproductive Medicine

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Both microdrop and open methods are commonly used for in vitro fertilization (IVF) protocols for embryo culture as well as oocyte insemination. However, few comparative studies evaluating the microdrop or open method of insemination on the fertilization outcome and subsequent embryo development have been performed. A randomized study was conducted to compare microdrop and open fertilization with respect to fertilization rate and embryo development among non-male factor patients undergoing in vitro fertilization and embryo transfer (IVF-ET). The results presented in this study demonstrate that the fertilization failure rate [total fertilization failure rate (TFF) plus low fertilization rate (<25% oocytes fertilized)] in the microdrop insemination group was higher than in the open insemination group (11.9% versus 3.3%, p < 0.001), while the good quality embryo rate and pregnancy rate did not differ significantly between the groups. As a highly complicated process involving many extrinsic and intrinsic factors, further studies are needed to confirm the effects of these insemination methods on the rate of fertilization failure.

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“…The resulting synchronization of follicles has shown to increase oocyte and embryo yield and therefore, the overall chances of pregnancy [67]. OCPs are perhaps the most frequently used pretreatment modality and their impact on IVF-ET cycles have been well studied in normal responders [7891011], poor responders [1221] and hyper-responders [22]. Conflicting data have been reported regarding the impact of OCP pretreatment on IVF-ET outcomes in normal responders, with some studies suggesting lower oocyte yield, clinical pregnancy, and live birth rates [1011] than observed in patients receiving no pretreatment, while other studies have not replicated these findings [7,14].…”

Section: Discussionmentioning

confidence: 99%

Pretreatment of normal responders in freshin vitrofertilization cycles: A comparison of transdermal estradiol and oral contraceptive pills

Pereira

Petrini

Zhou

et al. 2016

Clin Exp Reprod Med

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ObjectiveThe aim of this study was to investigate the impact of pretreatment with transdermal estradiol (E2) compared to oral contraceptive pills (OCPs) on controlled ovarian stimulation (COS) response in normal responders undergoing fresh in vitro fertilization (IVF)-embryo transfer (ET) cycles.MethodsA retrospective cohort study was performed of normal responders undergoing fresh IVF-ET cycles who received pretreatment with transdermal E2 versus OCPs prior to fresh IVF-ET. The total days of ovarian stimulation, total dosage of gonadotropins, total number of oocytes, and mature oocytes retrieved were noted. Pregnancy outcomes after ET were also recorded.ResultsA total of 2,092 patients met the inclusion criteria: 1,057 and 1,035 patients in the transdermal E2 and OCP groups, respectively. Patients in the OCP group had a longer duration of COS (10.7±1.63 days, p<0.01) than the E2 group (9.92±1.94 days). Patients in the OCP group also required higher cumulative doses of gonadotropins (2,657.3±1,187.9 IU) than those in the E2 group (2,550.1±1,270.2 IU, p=0.002). No statistically significant differences were found in the total and mature oocytes retrieved or in the rates of biochemical pregnancy, clinical pregnancy, spontaneous miscarriage, and live birth between the groups.ConclusionOur findings suggest that compared to OCPs, pretreatment with transdermal E2 is associated with a shorter duration of ovarian stimulation and lower gonadotropin utilization, without compromising the oocyte yield or pregnancy outcomes in normal-responder patients undergoing fresh IVF.

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Stimulation of the young poor responder: comparison of the luteal estradiol/gonadotropin-releasing hormone antagonist priming protocol versus oral contraceptive microdose leuprolide

Cited by 35 publications

References 18 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

Comparison of fertilization outcome between microdrop and open insemination methods in non-male factor IVF patients

Pretreatment of normal responders in freshin vitrofertilization cycles: A comparison of transdermal estradiol and oral contraceptive pills

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