Abstract
Stop GnRH-agonist combined with multiple-dose GnRH-antagonist protocol for patients with IVF failures due to poor embryo quality-A proof of concept
Highlights
Ovarian stimulation (OS) is a crucial step in the success of in vitro fertilization-embryo transfer (IVF-ET) because it allows the recruitment of multiple healthy fertilizable oocytes, correlating with cumulative live birth rate [1]
While many OS protocols and various adjuvant treatment strategies are proposed to poor responder patients with no compelling advantage for one protocol over another [2,3,4], the hitherto published studies concerning OS protocols for repeated IVF failures due to poor quality embryos are scarce [5,6]
In the present proof of concept study, we showed that patients suffering from repeated IVF failure and poor embryo quality might benefit from this protocol
Summary
Ovarian stimulation (OS) is a crucial step in the success of in vitro fertilization-embryo transfer (IVF-ET) because it allows the recruitment of multiple healthy fertilizable oocytes, correlating with cumulative live birth rate [1]. While attempting to examine the appropriate OS protocol in poor-responder patients, we found that combining the Stop GnRHagonist (-ag) protocol with GnRH-antagonist (-ant) protocols revealed significantly higher number of oocytes retrieved and top-quality embryos (TQE), with an acceptable clinical pregnancy rate [7]. The mid-luteal GnRH-ag pre-treatment causes down regulation of the GnRH receptors with the consequent suppression of pituitary LH secretion for as long as 10 days after the last dose of the agonist. This effect, together with the immediate LH suppression provided by the GnRH-ant, will eliminate premature LH surge and might improve the quality of the embryos generated
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