Comparison of multiple dose GnRH antagonist and minidose long agonist protocols in poor responders undergoing in vitro fertilization: a randomized controlled trial

Objective To investigate the efficacy of gonadotropin releasing hormone antagonist (GnRH) in poor responders undergoing in vitro fertilization. Study design Ninety-six patients with poor ovarian response in previous treatment cycles were prospectively randomized into two groups. Forty-four patients...

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Bibliographic Details
Published in:Archives of gynecology and obstetrics 2008-11, Vol.278 (5), p.467-472
Main Authors: Tazegül, Aybike, Görkemli, Hüseyin, Özdemir, Suna, Aktan, T. Murad
Format: Article
Language:English
Subjects:
Adult
Cohort Studies
Dose-Response Relationship, Drug
Drug Administration Schedule
Endocrinology
Female
Fertility Agents, Female - administration & dosage
Fertilization in Vitro
Gonadotropin-Releasing Hormone - administration & dosage
Gonadotropin-Releasing Hormone - analogs & derivatives
Gynecology
Hormone Antagonists - administration & dosage
Human Genetics
Humans
In vitro fertilization
Leuprolide - administration & dosage
Medicine
Medicine & Public Health
Obstetrics/Perinatology/Midwifery
Original Article
Ovulation Induction - methods
Pregnancy
Pregnancy Outcome
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Summary:Objective To investigate the efficacy of gonadotropin releasing hormone antagonist (GnRH) in poor responders undergoing in vitro fertilization. Study design Ninety-six patients with poor ovarian response in previous treatment cycles were prospectively randomized into two groups. Forty-four patients were stimulated with GnRH antagonist multidose protocol and 45 patients received a standard long agonist protocol. Ovarian response was evaluated by transvaginal ultrasound and hormonal parameters. Cycle characteristics and treatment outcomes were statistically compared between groups. Results There was significantly reduced duration of stimulation and consumption of gonadotrophins in the antagonist group when compared to the agonist group. The estradiol concentrations on the day of human chorionic gonadotropin (hCG) injection, the number of oocytes retrieved, and the number of embryos transferred were similar for both groups. In the antagonist group, eight (18.1%) ongoing pregnancies were achieved and in the agonist group, ten (22.2%) clinical pregnancies were achieved but the difference was not statistically significant. Conclusion The present study was not powered to detect clinically relevant differences between two protocols in outcomes such as pregnancy rate, with confidence.
ISSN:0932-0067
1432-0711
DOI:10.1007/s00404-008-0620-9