Comparison of microdose flare-up and antagonist multiple-dose protocols for poor-responder patients: a randomized study.
OBJECTIVE
To compare the efficacy of the microdose flare-up and multiple-dose antagonist protocols for poor-responder patients in intracytoplasmic sperm injection-ET cycles.


METHODS
A randomized, prospective study.


METHODS
Center for assisted reproductive technology in Turkey.


METHODS
Ninety patients with poor ovarian response in a minimum of two previous IVF cycles.


METHODS
All women were prospectively randomized into two groups by computer-assisted randomization. The patients in group 1 were stimulated according to the microdose flare-up protocol (n = 45), while the patients in group 2 were stimulated according to antagonist multiple-dose protocol (n = 45).


METHODS
The mean number of mature oocytes retrieved was the primary outcome measure, and fertilization rate, implantation rate per embryo, and clinical pregnancy rates were secondary outcome measures.


RESULTS
The mean age of the women, the mean duration of infertility, basal FSH level, and the number of previous IVF cycles were similar in both groups. The total gonadotropin dose used was significantly higher in group 2, while the number of oocytes retrieved was significantly greater in group 1. Although the fertilization and clinical pregnancy rates were nonsignificantly higher in group 1 compared with group 2, the implantation rate was significantly higher in the microdose flare-up group than in the multiple-dose antagonist group (22% vs. 11%).


CONCLUSIONS
The microdose flare-up protocol seems to have a better outcome in poor-responder patients, with a significantly higher mean number of mature oocytes retrieved and higher implantation rate.
Demirol
Aygul
A
Clinic Women Health, Infertility and IVF Center, Hacettepe University Faculty of Medicine, Ankara, Turkey. ademirol@gmail.com
Gurgan
Timur
T
D000328:Adult; D003131:Combined Modality Therapy; D003278:Contraceptives, Oral, Hormonal / Q000008:administration & dosage*; D004624:Embryo Transfer / Q000379:methods; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage*; D006727:Hormone Antagonists / Q000008:administration & dosage*; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D011256:Pregnancy Outcome; D016896:Treatment Outcome
D003278:Contraceptives, Oral, Hormonal; D006727:Hormone Antagonists; D007987:Gonadotropin-Releasing Hormone