title: A comparison among different methods of letrozole combined with gonadotropin in an antagonist protocol and high-dose gonadotropin ovarian stimulation antagonist protocol in poor ovarian responders undergoing in vitro fertilization.
abstract: This study aimed at comparing the effects of different methods of letrozole combined with gonadotropin (Gn) and high-dose Gn ovarian stimulation in antagonist protocol.
  
  
  
  Retrospectively reviewed 220 poor responders from August 2012 to July 2014 at Peking University Third Hospital Reproductive Medical Center. Patients were divided into Group 1 (LZ 5 mg for 5 days sequentially overlapping with Gn cycles; n = 60), group 2 (LZ 7.5 mg for 3 days sequentially with Gn cycles; n = 60), and group 3 (high-dose Gn cycles; n = 100). We compared the basic status of patients and clinical outcomes of the three groups.
  
  
  
  Basic characteristics of patients were comparable among groups. Group 1 had significantly higher LH levels on day 7 and hCG than Group 2 and 3 (P < 0.05). Group 1 had significantly higher early LH elevation rate (>20 IU/L) on the hCG day than Groups 2 and 3 (11.7 vs. 6.7 and 2.0 %; P < 0.05). The amount of Gn used in LZ groups was significantly lower than Group 3 (P < 0.01). However, the clinical pregnancy rate and live birth rate were comparable among groups.
  
  
  
  In conclusion, the LZ/antagonist protocol is a cost-effective and patient friendly protocol, LZ 5 mg for 5 days sequentially overlapping with Gn protocol has comparable pregnancy outcomes, and LZ 7.5 mg for 3 days sequentially with the Gn protocol even has better clinical outcomes when compared with the standard GnRH antagonist protocol in poor responders. LZ 7.5 mg for 3 days sequentially with the Gn protocol appeared to have resulted in fewer improper LH surges and better outcomes than LZ 5 mg for 5 days sequentially overlapping with Gn in antagonist protocol.
authors.affiliation: Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Yang
authors.affiliation: Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China. janelihz@yahoo.com.
authors.forename: Hongzhen
authors.initials: H
authors.lastname: Li
authors.affiliation: Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Li
authors.affiliation: Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Liu
authors.affiliation: Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China. jie.qiao@263.net.
authors.forename: Jie
authors.initials: J
authors.lastname: Qiao
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001723:Birth Rate; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors*; D006801:Humans; D000077289:Letrozole; D009570:Nitriles / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D014230:Triazoles / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D009570:Nitriles; D014230:Triazoles; D007987:Gonadotropin-Releasing Hormone; D000077289:Letrozole
keywords: Gonadotrophin-releasing hormone antagonist; In vitro fertilization; Letrozole; Poor ovarian responder