title: Corifollitropin alfa followed by hpHMG in GnRH agonist protocols. Two prospective feasibility studies in poor ovarian responders.
abstract: In two prospective uncontrolled feasibility trials, we examined the effect of corifollitropin alfa (CFA) followed by highly purified human menopausal gonadotrophin (hpHMG) in a short flare-up gonadotropin-releasing hormone (GnRH) agonist and a long GnRH agonist protocol for women with poor ovarian response. Overall, 45 patients were treated with short flare-up and 47 patients with the long agonist protocol. All patients received a single dose of 150 μg CFA, followed by 300 IU hpHMG 7 days later, triggering with 10 000 IU hCG, CSI and day 3 embryo transfer. Ongoing pregnancy rates (OPRs) did not differ between the short 15.6% and the long 17% agonist protocol (p = 0.85). Among patients treated with the short flare-up protocol, OPRs were 20% for younger patients (<40 years old) and 12% in older women (≥40 years old), p = 0.68. Similarly, in patients treated with the long agonist protocol younger women had an OPR of 26.7% versus 12.5% in older women, p = 0.23. Among patients treated with the short flare-up, live births rate were 15% and 4.3% for younger (<40 years old) and older patients (≥40 years old), respectively, p = 0.32. Similarly, in patients treated with the long agonist protocol, live births rate were 25% and 12.9% for younger (<40 years old) and older patients (≥40 years old), respectively, p = 0.41. None of the patients reported any serious adverse event related to treatment. According to our results, CFA followed by hpHMG in a short flare-up or long GnRH agonist protocol appears to be a feasible option for poor ovarian responders. Large phase III trials are mandatory prior to introduction in clinical practice.
authors.affiliation: a Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel , Brussels , Belgium .
authors.forename: Nikolaos P
authors.initials: NP
authors.lastname: Polyzos
authors.affiliation: a Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel , Brussels , Belgium .
authors.forename: Roberta
authors.initials: R
authors.lastname: Corona
authors.affiliation: a Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel , Brussels , Belgium .
authors.forename: Arne
authors.initials: A
authors.lastname: Van De Vijver
authors.affiliation: a Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel , Brussels , Belgium .
authors.forename: Christophe
authors.initials: C
authors.lastname: Blockeel
authors.affiliation: a Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel , Brussels , Belgium .
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Drakopoulos
authors.affiliation: a Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel , Brussels , Belgium .
authors.forename: Veerle
authors.initials: V
authors.lastname: Vloeberghs
authors.affiliation: a Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel , Brussels , Belgium .
authors.forename: Michel
authors.initials: M
authors.lastname: De Vos
authors.affiliation: a Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel , Brussels , Belgium .
authors.forename: Michel
authors.initials: M
authors.lastname: Camus
authors.affiliation: b The Fertility Clinic, Skive Regional Hospital , Skive , Denmark , and.|c Faculty of Health , Aarhus University , Aarhus , Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Humaidan
authors.affiliation: a Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel , Brussels , Belgium .
authors.forename: Herman
authors.initials: H
authors.lastname: Tournaye
mesh_terms: D000328:Adult; D002985:Clinical Protocols; D005240:Feasibility Studies; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D043373:Follicle Stimulating Hormone, Human / Q000627:therapeutic use*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D050498:Live Birth; D008186:Luteolytic Agents / Q000008:administration & dosage*; D008596:Menotropins / Q000627:therapeutic use*; D010062:Ovulation Induction / Q000379:methods*; D010865:Pilot Projects; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D017329:Triptorelin Pamoate / Q000008:administration & dosage*
chemical_list: D005300:Fertility Agents, Female; D043373:Follicle Stimulating Hormone, Human; D008186:Luteolytic Agents; C437186:follicle stimulating hormone, human, with HCG C-terminal peptide; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D008596:Menotropins
keywords: Bologna criteria; GnRH agonist; corifollitropin alfa; hpHMG; poor ovarian responders