Why lose an in vitro fertilization cycle when stimulation fails?

Area of Science:

• Reproductive Endocrinology
• In Vitro Fertilization (IVF)
• Ovarian Stimulation Protocols

Background:

• Gonadotropin-releasing hormone agonists (GnRH-a) are utilized in various ovarian stimulation protocols for IVF.
• The flare-up protocol, a common GnRH-a strategy, can sometimes lead to stimulation failure, particularly in poor responders.
• Cycle cancellation due to stimulation failure poses a significant challenge in assisted reproductive technologies.

Purpose of the Study:

• To evaluate the efficacy of an immediate switch to a long-acting GnRH-a analog in cases of flare-up protocol failure.
• To determine if this rescue strategy can prevent IVF cycle cancellation in poor responders.
• To assess the impact of this intervention on key IVF outcomes.

Main Methods:

• Patients experiencing stimulation failure with the flare-up protocol were switched to a long-acting GnRH-a analog.
• Follicular recruitment, oocyte quality, fertilization rates, and pregnancy rates were monitored.
• Comparison of outcomes between the rescue group and historical controls or standard protocols.

Main Results:

• The immediate switch to a long-acting GnRH-a analog successfully rescued IVF cycles that would have otherwise been canceled.
• This rescue strategy did not adversely affect follicle recruitment.
• Oocyte quality, fertilization, and pregnancy rates remained comparable to those achieved with standard protocols.

Conclusions:

• An immediate switch to a long-acting GnRH-a analog is an effective rescue strategy for poor responders experiencing flare-up protocol failure in IVF.
• This intervention prevents cycle cancellation without compromising reproductive outcomes.
• This approach offers a viable option to improve success rates in challenging IVF cases.