[Protocol of GNRH antagonist in poor responders in IVF-ET cycles].
BACKGROUND
Response to stimulation is one of the factors that affect the results of infertility treatment in IVF-ET cycles. Poor responders as well as the occurrence of ovulation prior to the oocyte retrieval is a main reason of nearly 30% of cancellations of the treatment cycles. In poor responders high doses of gonadotrophins are sometimes required. However administration of gonadotrophins alone does not prevent premature LH surge. The aim of the study was to assess controlled ovarian stimulation protocols with GnRH antagonists (Cetrotide) in poor responders.


METHODS
The study group consisted of 27 infertile women, mean age 35.8 (range 28-45) undergoing the second IVF cycle. In those women the first cycle was either cancelled due to the lack of follicles' development or the small number of growing follicles (1-2). Ovarian stimulation was started on the 2 day of cycle with administration of 225 IU or rFSH or hMG. Cetrotide was administered subcutaneously in a daily dose of 0.25 mg starting when estradiol serum concentration reached 150 pg/ml with a lead follicle 14 mm diameter and continued throughout the gonadotrophin treatment until HCG administration.


RESULTS
In 31 cycles the mean number of MII oocytes retrieved was 4.71 (range 1-10). In one woman there was no mature oocytes obtained during pick-up. In one case the cycle was cancelled due to the bad response. The mean duration of cetrotide administration was 5.16 days. The mean number of rFSH and HMG ampoules was 23 and 30 respectively. The fertilisation rate was 64%. Embryo transfer was performed on the 3rd day after pick-up. The pregnancy rate in this group was 22%. There weren't any adverse effects of Cetrotide in treated women. No case of ovarian hyperstimulation syndrome occurred.


CONCLUSIONS
Ovarian stimulation protocol with GnRH antagonist is effective in poor responders in IVF-ET cycles.
Grzechocińska
Barbara
B
I Kliniki i I Katedry Połoznictwa i Ginekologii AM w Warszawie.
Fracki
Stanisław
S
Marianowski
Piotr
P
Dworniak
Tomasz
T
Bablok
Leszek
L
Marianowski
Longin
L
D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D002985:Clinical Protocols; D004305:Dose-Response Relationship, Drug; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage* / Q000494:pharmacology; D005307:Fertilization in Vitro / Q000187:drug effects*; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage* / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors* / Q000494:pharmacology; D006801:Humans; D008875:Middle Aged; D009865:Oocytes / Q000187:drug effects*; D010062:Ovulation Induction / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome
D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D007987:Gonadotropin-Releasing Hormone; D005640:Follicle Stimulating Hormone; C062876:cetrorelix