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Microdose gonadotropin-releasing hormone agonist flare-up protocol versus multiple dose gonadotropin-releasing hormone antagonist protocol in poor responders undergoing intracytoplasmic sperm injection-embryo transfer cycle.
Fertil Steril. 2009 Jun; 91(6):2437-44.FS

Abstract

OBJECTIVE

To compare the efficacy of microdose GnRH agonist (GnRH-a) flare-up and multiple dose GnRH antagonist protocols in patients who have a poor response to a long luteal GnRH-a protocol.

DESIGN

Prospective, randomized, clinical study.

SETTING

University hospital.

PATIENT(S)

Forty-two poor responder patients undergoing intracytoplasmic sperm injection (ICSI)-embryo transfer cycle.

INTERVENTION(S)

Twenty-one patients received microdose leuprolide acetate (LA) (50 microg twice daily) starting on the second day of withdrawal bleeding. The other 21 patients received 0.25 mg of cetrorelix daily when the leading follicle reached 14 mm in diameter.

MAIN OUTCOME MEASURE(S)

Serum E(2) levels, number of growing follicles and mature oocytes, embryo quality, dose of gonadotropin used, cancellation, fertilization, implantation rate and pregnancy rate (PR).

RESULT(S)

The mean serum E(2) concentration on the day of hCG administration was significantly higher in the microdose GnRH-a group than in the GnRH antagonist group (1,904 vs. 1,362 pg/mL). The clinical PRs per started cycle of microdose GnRH-a and GnRH antagonist groups were 14.2% and 9.5%, respectively. There were no statistically significant differences in the other ovulation induction characteristics, fertilization and implantation rates.

CONCLUSION(S)

Microdose GnRH-a flare-up protocol and multiple dose GnRH antagonist protocol seem to have similar efficacy in improving treatment outcomes of poor responder patients.

Authors+Show Affiliations

Ankara University School of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey. korhankahraman@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

18555238

Citation

Kahraman, Korhan, et al. "Microdose Gonadotropin-releasing Hormone Agonist Flare-up Protocol Versus Multiple Dose Gonadotropin-releasing Hormone Antagonist Protocol in Poor Responders Undergoing Intracytoplasmic Sperm Injection-embryo Transfer Cycle." Fertility and Sterility, vol. 91, no. 6, 2009, pp. 2437-44.
Kahraman K, Berker B, Atabekoglu CS, et al. Microdose gonadotropin-releasing hormone agonist flare-up protocol versus multiple dose gonadotropin-releasing hormone antagonist protocol in poor responders undergoing intracytoplasmic sperm injection-embryo transfer cycle. Fertil Steril. 2009;91(6):2437-44.
Kahraman, K., Berker, B., Atabekoglu, C. S., Sonmezer, M., Cetinkaya, E., Aytac, R., & Satiroglu, H. (2009). Microdose gonadotropin-releasing hormone agonist flare-up protocol versus multiple dose gonadotropin-releasing hormone antagonist protocol in poor responders undergoing intracytoplasmic sperm injection-embryo transfer cycle. Fertility and Sterility, 91(6), 2437-44. https://doi.org/10.1016/j.fertnstert.2008.03.057
Kahraman K, et al. Microdose Gonadotropin-releasing Hormone Agonist Flare-up Protocol Versus Multiple Dose Gonadotropin-releasing Hormone Antagonist Protocol in Poor Responders Undergoing Intracytoplasmic Sperm Injection-embryo Transfer Cycle. Fertil Steril. 2009;91(6):2437-44. PubMed PMID: 18555238.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Microdose gonadotropin-releasing hormone agonist flare-up protocol versus multiple dose gonadotropin-releasing hormone antagonist protocol in poor responders undergoing intracytoplasmic sperm injection-embryo transfer cycle. AU - Kahraman,Korhan, AU - Berker,Bulent, AU - Atabekoglu,Cem Somer, AU - Sonmezer,Murat, AU - Cetinkaya,Esra, AU - Aytac,Rusen, AU - Satiroglu,Hakan, Y1 - 2008/06/13/ PY - 2007/11/26/received PY - 2008/03/23/revised PY - 2008/03/24/accepted PY - 2008/6/17/pubmed PY - 2009/7/9/medline PY - 2008/6/17/entrez SP - 2437 EP - 44 JF - Fertility and sterility JO - Fertil Steril VL - 91 IS - 6 N2 - OBJECTIVE: To compare the efficacy of microdose GnRH agonist (GnRH-a) flare-up and multiple dose GnRH antagonist protocols in patients who have a poor response to a long luteal GnRH-a protocol. DESIGN: Prospective, randomized, clinical study. SETTING: University hospital. PATIENT(S): Forty-two poor responder patients undergoing intracytoplasmic sperm injection (ICSI)-embryo transfer cycle. INTERVENTION(S): Twenty-one patients received microdose leuprolide acetate (LA) (50 microg twice daily) starting on the second day of withdrawal bleeding. The other 21 patients received 0.25 mg of cetrorelix daily when the leading follicle reached 14 mm in diameter. MAIN OUTCOME MEASURE(S): Serum E(2) levels, number of growing follicles and mature oocytes, embryo quality, dose of gonadotropin used, cancellation, fertilization, implantation rate and pregnancy rate (PR). RESULT(S): The mean serum E(2) concentration on the day of hCG administration was significantly higher in the microdose GnRH-a group than in the GnRH antagonist group (1,904 vs. 1,362 pg/mL). The clinical PRs per started cycle of microdose GnRH-a and GnRH antagonist groups were 14.2% and 9.5%, respectively. There were no statistically significant differences in the other ovulation induction characteristics, fertilization and implantation rates. CONCLUSION(S): Microdose GnRH-a flare-up protocol and multiple dose GnRH antagonist protocol seem to have similar efficacy in improving treatment outcomes of poor responder patients. SN - 1556-5653 UR - https://www.unboundmedicine.com/medline/citation/18555238/Microdose_gonadotropin_releasing_hormone_agonist_flare_up_protocol_versus_multiple_dose_gonadotropin_releasing_hormone_antagonist_protocol_in_poor_responders_undergoing_intracytoplasmic_sperm_injection_embryo_transfer_cycle_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(08)00727-9 DB - PRIME DP - Unbound Medicine ER -