title: Comparison of the ultrashort gonadotropin-releasing hormone agonist-antagonist protocol with microdose flare -up protocol in poor responders: a preliminary study.
abstract: OBJECTIVE
  To determine the potential effect of the ultrashort gonadotropin-releasing hormone (GnRH) agonist/GnRH antagonist protocol versus the microdose GnRH agonist protocol in poor responders undergoing intracytoplasmic sperm injection (ICSI).
  
  
  METHODS
  The patients in the Agonist-Antagonist Group (n=41) were administered the ultrashort GnRH-agonist/ antagonist protocol, while the patients in the Microdose Group (n=41) were stimulated according to the microdose flare-up protocol. The mean number of mature oocytes retrieved was the primary outcome measure. Fertilization rate, implantation rate per embryo and clinical pregnancy rates were secondary outcome measures.
  
  
  RESULTS
  There was no differenc between the mean number of mature oocytes retrieved in the two groups. There were also no statistical differences between the two groups in terms of peak serum E2 level, canceled cycles, endometrial thickness on hCG day, number of 2 pronucleus and number of embryos transferred. However, the total gonadotropin consumption and duration of stimulation were significantly higher with the Agonist-Antagonist Group compared with the Microdose Group. The implantation and clinical pregnancy rates were similar between the two groups.
  
  
  CONCLUSIONS
  Despite the high dose of gonadotropin consumption and longer duration of stimulation with the ultrashort GnRH agonist/ antagonist protocol, it seems that the Agonist-Antagonist Protocol is not inferior to the microdose protocol in poor responders undergoing ICSI.
authors.affiliation: Centre of Artificial Reproduction, Ankara University, Ankara, Turkey.
authors.forename: Bülent
authors.initials: B
authors.lastname: Berker
authors.affiliation: Centre of Artificial Reproduction, Fatih University, Ankara, Turkey.
authors.forename: Candan İltemir
authors.initials: Cİ
authors.lastname: Duvan
authors.affiliation: Department of Obstetrics and Gynecology, Ufuk University, Ankara, Turkey.
authors.forename: Cemil
authors.initials: C
authors.lastname: Kaya
authors.affiliation: Centre of Artificial Reproduction, Ankara University, Ankara, Turkey.
authors.forename: Ruşen
authors.initials: R
authors.lastname: Aytaç
authors.affiliation: Centre of Artificial Reproduction, Ankara University, Ankara, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Satıroğlu
keywords: Agonist-Antagonist protocol; Poor responder; mature oocytes; microdose flare-up protocol