Comparison of the ultrashort gonadotropin- releasing hormone agonist-antagonist protocol with microdose flare -up protocol in poor responders: a preliminary study Zayıf over cevaplı hastalarda ultra kısa GnRH agonist/antagonist protokolünün mikrodoz flare up protokolü ile karşılaştırılması

Address for Correspondence / Yazışma Adresi: Ass. Prof. Dr. Candan İltemir Duvan, Fatih University, Centre of Artificial Reproduction, Hosdere Cad. No: 145 P.K. 06540 Y. Ayrancı, Ankara, Turkey Phone: +90 312 409 88 88 Fax: +90 312 441 54 98 e.mail: [email protected] doi:10.5152/jtgga.2010.35 Objective: To determine the potential effect of the ultrashort gonadotropin-releasing hormone (GnRH) agonist/GnRH antagonist protocol versus the microdose GnRH agonist protocol in poor responders undergoing intracytoplasmic sperm injection (ICSI). Material and Methods: The patients in the Agonist-Antagonist Group (n=41) were administered the ultrashort GnRH-agonist/ antagonist protocol, while the patients in the Microdose Group (n=41) were stimulated according to the microdose flare-up protocol. The mean number of mature oocytes retrieved was the primary outcome measure. Fertilization rate, implantation rate per embryo and clinical pregnancy rates were secondary outcome measures. Results: There was no differenc between the mean number of mature oocytes retrieved in the two groups. There were also no statistical differences between the two groups in terms of peak serum E2 level, canceled cycles, endometrial thickness on hCG day, number of 2 pronucleus and number of embryos transferred. However, the total gonadotropin consumption and duration of stimulation were significantly higher with the Agonist-Antagonist Group compared with the Microdose Group. The implantation and clinical pregnancy rates were similar between the two groups. Conclusion: Despite the high dose of gonadotropin consumption and longer duration of stimulation with the ultrashort GnRH agonist/ antagonist protocol, it seems that the Agonist-Antagonist Protocol is not inferior to the microdose protocol in poor responders undergoing ICSI. (J Turkish-German Gynecol Assoc 2010; 11: 187-93)