Results of controlled ovarian stimulation for ART in poor responders according to the short protocol using different gonadotrophins combinations.
BACKGROUND
Improving pregnancy rates in intricate cases of ovarian stimulation remains a challenge during IVF and intracytoplasmic sperm injection (ICSI). Different protocols of ovulation induction have been proposed.


METHODS
The short protocol of ovarian stimulation using recombinant follicle-stimulating hormone (rFSH) with or without the use of luteinizing hormone (LH) in IVF or ICSI outcome in patients with many failed attempts and maternity age > or = 37 years was investigated. The prognostic significance of high but normal values of day 3 serum FSH concentrations was also evaluated.


RESULTS
Results show that FSH levels of >9 mIU/ml are associated with poor results even with the use of human menopausal gonadotrophin (HMG). Results were generally comparable when rFSH was used alone or in combination with HMG, except for the quality and the number of embryos transferred, the later being better in the rFSH + HMG group.


CONCLUSIONS
In conclusion intricate cases have good chances for achieving a pregnancy using the short protocol and the outcome is further improved when LH is added from the beginning of ovarian stimulation. A slight elevation of day 3 FSH seems to be a strong prognostic factor for a poor outcome.
D000328:Adult; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004622:Embryo, Mammalian / Q000502:physiology; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood / Q000627:therapeutic use*; D006062:Gonadotropins / Q000627:therapeutic use*; D006801:Humans; D007986:Luteinizing Hormone / Q000627:therapeutic use; D008423:Maternal Age; D008596:Menotropins / Q000627:therapeutic use; D009994:Osmolar Concentration; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011379:Prognosis; D011994:Recombinant Proteins / Q000627:therapeutic use; D019233:Retreatment; D020554:Sperm Injections, Intracytoplasmic; D013997:Time Factors
D006063:Chorionic Gonadotropin; D006062:Gonadotropins; D011994:Recombinant Proteins; D008596:Menotropins; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone