2008
DOI: 10.1016/j.fertnstert.2007.06.022
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Ultrashort gonadotropin-releasing hormone agonist combined with flexible multidose gonadotropin-releasing hormone antagonist for poor responders in in vitro fertilization/embryo transfer programs

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Cited by 41 publications
(26 citation statements)
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“…In this study, the authors compared the use of the ultrashort GnRH-agonist combined with the flexible GnRH-antagonist in 21 poor responder patients with the patient's previous cycle. They found a significantly greater number of follicles larger than 14 mm, a higher number of oocytes retrieved and embryos transferred, and a reasonable clinical pregnancy rate (14.3%) [9]. In a follow up manuscript, the same authors reported that the use of the ultrashort flare GnRH-agonist combined with flexible multidose GnRH-antagonist for patients with repeated IVF failures again showed improvement when compared to the patient's previous cycle [8].…”
Section: Discussionmentioning
confidence: 95%
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“…In this study, the authors compared the use of the ultrashort GnRH-agonist combined with the flexible GnRH-antagonist in 21 poor responder patients with the patient's previous cycle. They found a significantly greater number of follicles larger than 14 mm, a higher number of oocytes retrieved and embryos transferred, and a reasonable clinical pregnancy rate (14.3%) [9]. In a follow up manuscript, the same authors reported that the use of the ultrashort flare GnRH-agonist combined with flexible multidose GnRH-antagonist for patients with repeated IVF failures again showed improvement when compared to the patient's previous cycle [8].…”
Section: Discussionmentioning
confidence: 95%
“…The concept of using a short-term microdose GnRH agonist followed by a GnRH antagonist during stimulation has recently been presented as an additional alternative protocol for poor responders [3,4,8,9]. This protocol combines the benefit of the initial stimulatory effect of the agonist flare on endogenous FSH, with the LH suppression provided by the antagonist.…”
Section: Discussionmentioning
confidence: 99%
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“…In addition, the impact of these protocols on endometrial receptivity also remains controversial (15,16). As a result, neither of these protocols has been effective in improving ART outcomes in this subgroup of patients (7,17,18). The idea of the combination of the microdose GnRH-a flare-up and GnRH antagonist protocol to minimize these detrimental effects and to combine the beneficial effects of these two stimulation protocols for poor responders was first presented by Berger et al as a novel protocol -the "Agonist-Antagonist Protocol (AAP)" (19).…”
Section: Introductionmentioning
confidence: 99%
“…In an attempt to distinguish the optimal approach by means of stimulation protocol for these patients, the combined ultrashort GnRH agonist/GnRH antagonist (ultrashort GnRH-ag/GnRH-ant) protocol has been reported to result in a significantly higher number of follicles with a higher yield of oocytes retrieved and embryos transferred, as well as a reasonable clinical pregnancy rate in patients with previous failed IVF attempts and poor embryo quality (8). The rationale of employing this protocol for POR lies within the separate benefits that the accompanying adjuncts, prior to ovarian stimulation, may offer: Firstly, estradiol pretreatment prevents corpus luteum formation and the ensuing hormonal stimulation.…”
mentioning
confidence: 99%