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The Immediate Partial Removal of Cumulus-Oocyte Complexes: A Refined Approach for Rapid Observation of In Vitro Fertilization
Published on: October 18, 2024
A comparison of three downregulation approaches for poor responders undergoing in vitro fertilization
Laura Detti1, Daniel B Williams, Jared C Robins
1Division of Reproductive Endocrinology, Center for Reproductive Health, University of Cincinnati Medical Center, Cincinnati, Ohio, USA.
Objective:
To assess the efficacy of three different GnRH agonist (GnRH-a) stimulation regimens to improve ovarian response in poor responders undergoing IVF.
Design:
Retrospective cohort study.
Setting:
Center for Reproductive Health at the University of Cincinnati Medical Center.
Patient(S):
Women diagnosed as poor responders who presented consecutively from January 1999 to January 2004.
Intervention(S):
Patients underwent three different stimulation regimens during IVF cycles: [1] stop protocol: GnRH-a 500 microg/d administered from the midluteal phase to the start of menses, then gonadotropins from day 2 of cycle, [2] microdose flare: GnRH-a 20 microg administered twice daily with gonadotropins from day 2 to the day of hCG administration, or [3] regular dose flare: gonadotropins beginning with GnRH-a on day 2 at 1 mg/d for 3 days, followed by 250 microg/d until the day of hCG administration.
Main Outcome Measure(S):
Ovarian response, implantation rates, clinical pregnancy and delivery rates.
Result(S):
Sixty-one IVF cycles were included in the study. None of the comparisons reached statistical significance; however, the microdose group demonstrated a trend toward a higher completed pregnancy rate.
Conclusion(S):
The microdose flare protocol for poor responders demonstrated a trend toward higher delivery rates. A larger prospective study would need to be performed to determine whether this trend leads to a significant finding in this patient population.
