Corifollitropin alfa followed by rFSH in a GnRH antagonist protocol for poor ovarian responder patients: an observational pilot study.
OBJECTIVE
To identify whether women with poor ovarian response may benefit from treatment with corifollitropin alfa in a GnRH antagonist protocol.


METHODS
Retrospective pilot study.


METHODS
University-based tertiary care center.


METHODS
Poor ovarian responders fulfilling the Bologna criteria developed by European Society for Human Reproduction and Embryology Consensus Group.


METHODS
Corifollitropin alfa (150 μg) followed by 300 IU rFSH in a GnRH antagonist protocol.


METHODS
Endocrinologic profile and ongoing pregnancy rates.


RESULTS
Among 43 women treated with corifollitropin alfa, mean E(2) levels showed an increasing pattern during the follicular phase, reaching 825 ng/L on the day of hCG administration, whereas FSH values showed a marked increase during the first 5 days, reaching a mean value of 35 IU/L and remaining above 20 IU/L during the late follicular phase. Cycle cancellation rate was 32.6% and embryo transfer rate 53.3%. Five patients (11.7%) had a positive hCG test and three (7%) had an ongoing pregnancy. Ongoing pregnancy rates were 11.1% per oocyte retrieval and 13% per embryo transfer. Ongoing pregnancy rates per patient did not significantly differ compared with a cohort of patients treated during 2011 with the standard protocol for poor responders in our center (short agonist-hMG) (7% vs. 6.3%).


CONCLUSIONS
Treatment of poor ovarian responders, as described by the Bologna criteria, with corifollitropin alfa in a GnRH antagonist protocol results in low pregnancy rates, similarly to conventional stimulation with a short agonist protocol.
Center for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium. nikolaos.polyzos@uzbrussel.be
Nikolaos P
NP
Polyzos
Michel
M
Devos
Peter
P
Humaidan
Dominic
D
Stoop
Carolina
C
Ortega-Hrepich
Paul
P
Devroey
Herman
H
Tournaye
D000328:Adult; D004359:Drug Therapy, Combination; D005260:Female; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage*; D043373:Follicle Stimulating Hormone, Human / Q000008:administration & dosage*; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors*; D006727:Hormone Antagonists / Q000008:administration & dosage; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis* / Q000188:drug therapy*; D010062:Ovulation Induction / Q000379:methods*; D010865:Pilot Projects; D011247:Pregnancy; D011256:Pregnancy Outcome; D011994:Recombinant Proteins; D012189:Retrospective Studies; D016896:Treatment Outcome
D043373:Follicle Stimulating Hormone, Human; D006727:Hormone Antagonists; D011994:Recombinant Proteins; C437186:follicle stimulating hormone, human, with HCG C-terminal peptide; D007987:Gonadotropin-Releasing Hormone; D005640:Follicle Stimulating Hormone