Abstract
Background: This study aimed to determine if the gonadotropin releasing hormone (GnRH) antagonist protocol is optimal for expected poor ovarian responders with tubal factor undergoing in vitro fertilization-embryo transfer (IVF-ET). Methods: A total of 341 IVF-ET cycles were retrospectively identified. The following inclusion criteria were applied: age ≥ 40 years and patients with tubal factors. The cycles were divided into two groups: a GnRH antagonist group (157 cycles) and a GnRH agonist group (184 cycles). Results: The duration of stimulation and the total doses of gonadotropin in the GnRH agonist group were significantly more than those in the GnRH antagonist group (P < 0.05). There were significant differences in LH and P values on the hCG measurement days between the two groups (0.91 ± 1.17 vs. 4.82 ± 4.69 U/L and 0.69 ± 0.42 vs. 1.03 ± 0.50 ng/mL, P < 0.05). The implantation rate of the GnRH antagonist group was 12.24%, which was slightly higher than that of the GnRH agonist group (10.10%, P = 0.437). The clinical pregnancy rate of the two groups showed no statistical differences (23.36% vs. 23.03%, P = 1.000). Conclusion: For expected poor ovarian responders, the GnRH antagonist protocol was, to some extent, superior to the GnRH agonist protocol in terms of the implantation and clinical pregnancy rates.
Highlights
This study aimed to determine if the gonadotropin releasing hormone (GnRH) antagonist protocol is optimal for expected poor ovarian responders with tubal factor undergoing in vitro fertilization-embryo transfer (IVF-embryo transfers (ET))
According to the Bologna criteria, poor ovarian response (POR) should be diagnosed if the patients have two out of the following three features: 1) advanced age (≥40 years) or any other risk factor for POR; 2) a history of POR; or 3) lower ovarian reserve [antral follicular count (AFC) less than 5 - 7 follicles or Anti-Mullerian hormone (AMH) level less than 0.5 ng/mL to 1.1 ng/mL] [3]
We investigated the effectiveness of the GnRH antagonist protocol in expected poor ovarian responders
Summary
This study aimed to determine if the gonadotropin releasing hormone (GnRH) antagonist protocol is optimal for expected poor ovarian responders with tubal factor undergoing in vitro fertilization-embryo transfer (IVF-ET). Results: The duration of stimulation and the total doses of gonadotropin in the GnRH agonist group were significantly more than those in the GnRH antagonist group (P < 0.05). Conclusion: For expected poor ovarian responders, the GnRH antagonist protocol was, to some extent, superior to the GnRH agonist protocol in terms of the implantation and clinical pregnancy rates. According to the Bologna criteria, POR should be diagnosed if the patients have two out of the following three features: 1) advanced age (≥40 years) or any other risk factor for POR; 2) a history of POR (three or fewer oocytes retrieved with ovulation induction); or 3) lower ovarian reserve [antral follicular count (AFC) less than 5 - 7 follicles or Anti-Mullerian hormone (AMH) level less than 0.5 ng/mL to 1.1 ng/mL] [3]
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