title: Comparison of different stimulation protocols efficacy in poor responders undergoing IVF: a retrospective study.
abstract: OBJECTIVE
  To compare the efficacy of different stimulation protocols on pregnancy outcomes in poor responders undergoing in vitro fertilization (IVF).
  
  
  METHODS
  This was a retrospective study to compare the efficacy of four different protocols including gonadotropin-releasing hormone (GnRH) agonist (long, short and miniflare) and GnRH antagonist on pregnancy outcomes in poor responders. This investigation was performed on 566 poor respond patients who were candidates for IVF. Main outcome measures included the total number of oocytes and mature oocytes retrieved, pregnancy rates, implantation and overall cancellation rates which were compared between four mentioned groups.
  
  
  RESULTS
  Number of follicles >18 mm on hCG day were significantly higher in GnRH-a long versus GnRH antagonist, GnRH-a short and GnRH-a miniflare protocols. The mean number of oocytes and mature oocytes retrieved were significantly higher in GnRH-a long versus miniflare (4.7 ± 3.05 versus 3.26 ± 2.9 and 3.69 ± 3.1 versus 2.65 ± 2.2, respectively). There were no significant differences in implantation, pregnancy and overall cancellation rates between four groups.
  
  
  CONCLUSIONS
  The present study suggests that the application of four different protocols in poor respond patients seem to have similar efficacy in improving clinical outcomes such as implantation, pregnancy rates and cancellation rate even though GnRH-a long protocol yielded more retrieved oocytes and mature oocytes compared to GnRH-a miniflare protocol.
authors.affiliation: Department of Endocrinology and Female Infertility, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran. tmadani @royaninstitute.org
authors.forename: Tahereh
authors.initials: T
authors.lastname: Madani
authors.forename: Mahnaz
authors.initials: M
authors.lastname: Ashrafi
authors.forename: Ladan Mohammadi
authors.initials: LM
authors.lastname: Yeganeh
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists / Q000037:antagonists & inhibitors; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy* / Q000628:therapy; D010053:Ovary / Q000187:drug effects; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012102:Reproductive Control Agents / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D006063:Chorionic Gonadotropin; D006727:Hormone Antagonists; D012102:Reproductive Control Agents; D007987:Gonadotropin-Releasing Hormone