Antagonists in poor-responder patients.
To review treatment options for poor-responding patients who are undergoing infertility treatment. Review article and case studies.A comprehensive determination of potential ovarian response for the poor-responding patient is important in the individualization of treatment options for these patients. Treatment options include both the microdose flare leuprolide acetate and GnRH antagonist stimulation protocols. For GnRH antagonist stimulation protocols, individualization of treatment includes use of oral contraceptive pretreatment and alterations in duration of gonadotropin stimulation and start day of antagonist administration. For poor-responding patients, the benefits of using GnRH antagonists for the suppression of premature LH surges plus the determination that stimulation protocols that include GnRH antagonists are at least as good as the microdose flare and provide better cycle outcomes than the long luteal leuprolide acetate down-regulation protocols have the potential to bring changes to the existing protocols for ovarian stimulation.
Copperman
Alan B
AB
Mount Sinai School of Medicine, New York, New York 10022, USA. acopperman@rmaofny.com
D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives / Q000037:antagonists & inhibitors* / Q000627:therapeutic use*; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy*; D007986:Luteinizing Hormone / Q000378:metabolism; D008597:Menstrual Cycle / Q000187:drug effects; D006080:Ovarian Follicle / Q000187:drug effects / Q000502:physiology; D012189:Retrospective Studies
D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone