Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 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.

PubMed Disclaimer

Conflict of interest statement

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

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Surrey ES. Management of the poor responder: the role of GnRH agonists and antagonists. J Assist Reprod Genet. 2007;24:613–619. - PMC - PubMed
    1. Porter RN, Smith W, Craft IL, Abdulwahid NA, Jacobs HS. Induction of ovulation for in-vitro fertilisation using buserelin and gonadotropins. Lancet. 1984;2:1284–1285. - PubMed
    1. Feldberg D, Farhi J, Ashkenazi J, Dicker D, Shalev J, Ben-Rafael Z. Minidose gonadotropin-releasing hormone agonist is the treatment of choice in poor responders with high follicle-stimulating hormone levels. Fertil Steril. 1994;62:343–346. - PubMed
    1. Olivennes F, Righini C, Fanchin R, Torrisi C, Hazout A, Glissant M, et al. A protocol using a low dose of gonadotrophin-releasing hormone agonist might be the best protocol for patients with high follicle-stimulating hormone concentrations on day 3. Hum Reprod. 1996;11:1169–1172. - PubMed
    1. De Placido G, Mollo A, Clarizia R, Strina I, Conforti S, Alviggi C. Gonadotropin-releasing hormone (GnRH) antagonist plus recombinant luteinizing hormone vs. a standard GnRH agonist short protocol in patients at risk for poor ovarian response. Fertil Steril. 2006;85:247–250. - PubMed