Intracytoplasmic Sperm Injection Outcome in Patient at Risk of Poor Responder Using Mild Ovarian Stimulation Protocol versus Short Gonadotropin Releasing Hormone Agonist Protocol

Abstract

Background: Poor ovarian response to stimulation in IVF cycles is a challenging and frustrating condition for both clinician and patient, due to its poor prognosis in terms of pregnancies and live births. Although in the literature a large number of papers have been published in which many stimulation protocols suggested should be considered as the best for these women, however, no conclusive results have been reached. Aim of the Work: To evaluate ICSI outcome in patient at risk of poor responder using mild ovarian stimulation protocol versus short gonadotropins releasing hormone agonist protocol. Patients and Methods: This randomized controlled study was conducted on one hundred patients, complaining of infertility at risk of poor responders, patients with at least two of the criteria specific for poor responders at assisted reproductive technology unit, international Islamic center for population studies and research, Alazhar University, Cairo, Egypt, between august 2016 and august 2017. Results: Statistically significant differences were found in the Endometrial thickness, E2 at day of HCG, No. of dominant follicles at day of HCG, Number of retrieved oocyte, fertilization rate, Embryo number, Number of transferred embryos, Pregnancy rate and cost p-value 0.029, 0.036, 0.007, 0.027, 0.048, 0.019, 0.046, 0.044 ,0.001 respectively. Conclusion: ICSI outcome was evaluated in patients at risk of poor responders using short Gonadotropin releasing hormone agonist versus mild ovarian stimulation protocol (clomiphene citrate); showing that short Gonadotropin releasing hormone agonist should be preferred in these patients.