Comparison of luteal estradiol patch and gonadotropin-releasing hormone antagonist suppression protocol before gonadotropin stimulation versus microdose gonadotropin-releasing hormone agonist protocol for patients with a history of poor in vitro fertilization outcomes.
OBJECTIVE
To compare IVF outcomes in poor-responder patients undergoing stimulation after luteal phase E(2) patch/GnRH antagonist (LPG) protocol versus microdose GnRH agonist protocol.


METHODS
Retrospective analysis.


METHODS
University-based IVF center.


METHODS
Forty-five women undergoing ovarian stimulation for IVF using the LPG protocol were compared with 76 women stimulated with the microdose GnRH agonist protocol from May 2005 to April 2006.


METHODS
Cancellation rate, number of oocytes retrieved, and clinical pregnancy rates.


RESULTS
The mean number of oocytes (9.1 +/- 4.1 vs. 8.9 +/- 4.3) and mature oocytes (6.7 +/- 3.5 vs. 6.8 +/- 3.1) retrieved were similar, as were the fertilization rates (70.0% +/- 24.2% vs. 69.9% +/- 21.5%) and the number of embryos transferred (2.5 +/- 1.1 vs. 2.7 +/- 1.3). The cancellation rate was not significantly different between the groups (13/45, 28.9% vs. 23/76, 30.3%). Likewise, there were no significant differences among the implantation rate (15.0% vs. 12.5%), clinical pregnancy rate (43.3% vs. 45.1%), and ongoing pregnancy rate per transfer (33.3% vs. 26.0%) between both groups.


CONCLUSIONS
This study demonstrates that the use of an E(2) patch and a GnRH antagonist during the preceding luteal phase in patients with a history of failed cycles can provide similar IVF outcomes when compared with the microdose GnRH agonist protocol.
Weitzman
Vanessa N
VN
Center for Advanced Reproductive Services, Department of Obstetrics and Gynecology, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030-6224, USA.
Engmann
Lawrence
L
DiLuigi
Andrea
A
Maier
Donald
D
Nulsen
John
J
Benadiva
Claudio
C
D000328:Adult; D015992:Body Mass Index; D003276:Contraceptives, Oral / Q000494:pharmacology; D003338:Corpus Luteum / Q000502:physiology*; D004715:Endometriosis / Q000453:epidemiology; D004958:Estradiol / Q000627:therapeutic use*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005640:Follicle Stimulating Hormone / Q000097:blood; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors* / Q000627:therapeutic use; D006062:Gonadotropins / Q000627:therapeutic use*; D006801:Humans; D007889:Leiomyoma / Q000453:epidemiology; D008597:Menstrual Cycle / Q000187:drug effects; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D012189:Retrospective Studies; D017211:Treatment Failure
D003276:Contraceptives, Oral; D006062:Gonadotropins; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D005640:Follicle Stimulating Hormone