Comparison of agonistic flare-up and antagonistic multiple dose protocols in controlled ovarian hyper-stimulation of young poor responders with low basal follicle-stimulating hormone levels undergoing ICSI

Abstract EN

-Objective: ثلآ compare stimulation profiles and pregnancy rate in poor responders during Intracytoplasmic sperm injection(ICSI) cycles using either a GnRH agonist flare protocol (Triptoreline) or a GnRH antagonist (c^rorelix). Design: prospective, case-control study. were noted in total stimulation duration(11.5 versus 10.5 days), peak estradiol level (1429 versus 1448 pg/ml) , amount of gonadotropins used (76 versus 74 ampoules),cancellation rate(37.1% versus 37.5%), number of oocytes obtained (5.6 versus 5.8),or embryos transferred(1.9 versus 2.1) .

The implantation rate (13.3% versus 13.6%) and clinical pregnancy per transfer (21% versus 26%) in the GnRH agonist flare-up and antagonist groups, respectively, were similar. Conclusion: Both the standard dose flare-up and the antagonist protocols significantly improved the ovarian response of known poor responders.

However, no statistically significant differences were observed between the two protocols regarding clinical pregnancy rates.

In patients with poor prognosis for ovarian response, the flare-up agonist and the antagonist protocols were comparable regarding clinical pregnancy rates. Setting: Assisted Reproduction ^chnology Unit, International Islamic Center for Population Studies & Research, Al-Azhar University. Methods: Sixty seven women aged < 35 years and basal FSH< 10IU/L designated as poor responders based on a prior stimulating cycle. Intervention: Administration of GnRH agonist flare or GnRH antagonist protocols. Main Outcome Measures: Stimulation profiles and clinical pregnancy rate. Results: For 35 patients on GnRH agonist flar^-up and 32 patients on GnRH antagonist protocols, the groups were similar with respect to age(33.6 versus 32.2 years),body mass index(28.2 versus 27.8 Kg/m2) and basal FSH concentration (7.3 versus 7.8 IU/L).

No statisticaily significant differences between the protocol types