Comparison of estradiol and progesterone priming/antagonist/letrozole and microdose flare-up protocols for poor responders undergoing intracytoplasmic sperm injection.
BACKGROUND
To compare the effect of the GnRH antagonist/letrozole/gonadotropin protocol with the microdose GnRH agonist flare-up protocol in poor ovarian responders for intracytoplasmic sperm injection.


METHODS
One hundred twenty-one consecutive patients suspected of having or with a history of poor ovarian response between January 2009 and June 2010, who were undergoing ICSI were enrolled. The microdose flareup (MF) protocol was used in 79 patients and the estradiol + progesterone/letrozole + gonadotropin and GnRH antagonist (EP/ALG) protocol was used in 42 patients.


RESULTS
Age of the patients, duration of infertility, basal FSH, the total gonadotropin consumption, duration of stimulation, E2 level on the day of hCG administration, the number of embryo transferred, the fertilization rate, implantation rate, clinical pregnancy rate and the live birth rate were not statistically different (p > 0.05). Only the number of oocytes retrieved was significantly higher in the EP/LGA group (1.7 ± 0.7 versus 2.6 ± 0.6).


CONCLUSIONS
The EP/LGA protocol has no significant improvement against the microdose flare-up protocol in poor responder patients.
Department of Obstetrics and Gynecology, Suleymaniye Maternity and Children's Teaching and Research Hospital , Istanbul , Turkey .
Oguz
O
Yucel
Murat
M
Ekin
Hüseyin
H
Cengiz
Ali Galip
AG
Zebitay
Sener
S
Yalcinkaya
Sercin
S
Karahuseyinoglu
D000328:Adult; D004958:Estradiol / Q000008:administration & dosage*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists* / Q000037:antagonists & inhibitors; D006801:Humans; D000077289:Letrozole; D009570:Nitriles / Q000008:administration & dosage*; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000008:administration & dosage*; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D014230:Triazoles / Q000008:administration & dosage*
D009570:Nitriles; D014230:Triazoles; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D004958:Estradiol; D000077289:Letrozole
Assisted reproductive technology; estrogens; infertility; ovulation induction