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. 2011 Dec;38(4):228-33.
doi: 10.5653/cerm.2011.38.4.228. Epub 2011 Dec 31.

GnRH antagonist multiple dose protocol with oral contraceptive pill pretreatment in poor responders undergoing IVF/ICSI

Chung-Hoon Kim  1 , Rae-Mi You, Hyuk-Jae Kang, Jun-Woo Ahn, Ilkyung Jeon, Ji-Won Lee, Sung-Hoon Kim, Hee-Dong Chae, Byung-Moon Kang
Affiliations

GnRH antagonist multiple dose protocol with oral contraceptive pill pretreatment in poor responders undergoing IVF/ICSI

Chung-Hoon Kim et al. Clin Exp Reprod Med. 2011 Dec.

Abstract

Objective: To investigate the effectiveness of GnRH antagonist multiple-dose protocol (MDP) with oral contraceptive pill (OCP) pretreatment in poor responders undergoing IVF/ICSI, compared with GnRH antagonist MDP without OCP pretreatment and GnRH agonist low-dose long protocol (LP).

Methods: A total of 120 poor responders were randomized into three groups according to controlled ovarian stimulation (COS) options; GnRH antagonist MDP after OCP pretreatment (group 1), GnRH antagonist MDP without OCP pretreatment (group 2) or GnRH agonist luteal low-dose LP without OCP pretreatment (group 3). Patients allocated in group 1 were pretreated with OCP for 21days in the cycle preceding COS, and ovarian stimulation using recombinant human FSH (rhFSH) was started 5 days after discontinuation of OCP.

Results: There were no differences in patients' characteristics among three groups. Total dose and days of rhFSH used for COS were significantly higher in group 3 than in group 1 or 2. The numbers of mature oocytes, fertilized oocytes and grade I, II embryos were significantly lower in group 2 than in group 1 or 3. There were no significant differences in the clinical pregnancy rate and implantation rate among three groups.

Conclusion: GnRH antagonist MDP with OCP pretreatment is at least as effective as GnRH agonist low-dose LP in poor responders and can benefit the poor responders by reducing the amount and duration of FSH required for follicular maturation.

Keywords: Agonist; Antagonist; Gonadotropin-releasing hormone; Human; In vitro fertilization; Intracytoplasmic sperm injection; Oral Contraceptives; Poor Responders.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

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