A controlled trial of natural cycle versus microdose gonadotropin-releasing hormone analog flare cycles in poor responders undergoing in vitro fertilization.
OBJECTIVE
To determine the efficacy of natural-cycle IVF compared with controlled ovarian hyperstimulation in poor responders.


METHODS
Randomized, controlled study.


METHODS
Private center for assisted reproduction.


METHODS
One hundred twenty-nine women who were poor responders in a previous IVF cycle.


METHODS
Fifty-nine women underwent 114 attempts of natural-cycle IVF, and 70 women underwent 101 attempts of IVF with controlled ovarian hyperstimulation with microdose GnRH analog flare.


METHODS
Number of oocytes retrieved, pregnancy rate (PR) per cycle, PR per transfer, and implantation rate.


RESULTS
The poor responders treated with natural-cycle IVF and those treated with micro-GnRH analog flare showed similar PRs per cycle and per transfer. The women treated with natural-cycle IVF showed a statistically significant higher implantation rate (14.9%) compared with controls (5.5%). When subdivided into three groups according to age (<or=35 years, >or=36-39 years, >or=40 years), younger patients had a better PR than the other two groups.


CONCLUSIONS
In poor responders, natural-cycle IVF is at least as effective as controlled ovarian hyperstimulation, especially in younger patients, with a better implantation rate.
Morgia
Francesco
F
Bioroma Centro di Riproduzione Assistita Casa di Cura "Paideia, Rome, Italy.
Sbracia
Marco
M
Schimberni
Mauro
M
Giallonardo
Annalise
A
Piscitelli
Claudio
C
Giannini
Pierluigi
P
Aragona
Cesare
C
D000328:Adult; D002064:Buserelin / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004624:Embryo Transfer; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage*; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives*; D006801:Humans; D008297:Male; D008423:Maternal Age; D008597:Menstrual Cycle; D008875:Middle Aged; D010062:Ovulation Induction; D011247:Pregnancy; D018873:Pregnancy Rate; D019233:Retreatment; D020554:Sperm Injections, Intracytoplasmic
D005300:Fertility Agents, Female; D007987:Gonadotropin-Releasing Hormone; D002064:Buserelin