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Randomized Controlled Trial
. 2020 Jan;148(1):59-64.
doi: 10.1002/ijgo.12988. Epub 2019 Oct 18.

Randomized controlled trial of gonadotropin-releasing hormone agonist microdose flare-up versus flare-up among poor responders undergoing intracytoplasmic sperm injection

Firouzeh Ghaffari  1 , Nadia Jahangiri  1 , Tahereh Madani  1 , Shabnam Khodabakhshi  1 , Mohammad Chehrazi  2
Affiliations
Randomized Controlled Trial

Randomized controlled trial of gonadotropin-releasing hormone agonist microdose flare-up versus flare-up among poor responders undergoing intracytoplasmic sperm injection

Firouzeh Ghaffari et al. Int J Gynaecol Obstet. 2020 Jan.

Abstract

Objective: To compare the effect of gonadotropin-releasing hormone (GnRH) agonist microdose flare-up and GnRH agonist flare-up protocols among women with poor ovarian reserve undergoing intracytoplasmic sperm injection (ICSI) cycles.

Methods: Randomized controlled trial study among 131 women with poor ovarian reserve who underwent ICSI cycles at a single center in Tehran, Iran, between September 2008 and May 2014. Eligible women were randomly assigned to either the microdose flare-up (n=66) or flare-up (n=65) protocol. The primary outcome measure was live birth rate.

Results: Both groups were comparable in cycle cancellation, mean number of dominant follicles, retrieved oocytes, and metaphase II oocytes. Number of stimulation days (P=032) and endometrial thickness (P=0.001) were significantly higher, and gonadotropin dose was non-significantly higher (P=0.075) in the microdose flare-up group than in the flare-up group. No difference in clinical pregnancy, implantation, or abortion rate was observed between the two protocols. Live birth was higher in the microdose flare-up group than in the flare-up group (P=0.036).

Conclusion: The microdose flare-up protocol seemed to be superior to the flare-up protocol, but it required a higher dose of gonadotropins and a longer duration of stimulation. Further prospective clinical trials of the microdose flare-up protocol are recommended. CLINICALTRIALS.GOV: NCT01006954.

Keywords: Embryo transfer; GnRH agonist flare-up; Gonadotropin-releasing hormone; Infertility; Intracytoplasmic sperm injection; Microdose GnRH agonist flare-up; Poor ovarian response; Randomized controlled trial.

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References

REFERENCES

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