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Updated: Jun 5, 2026

Fertility Preservation in Patients with Severe Ovarian Dysfunction
Published on: March 25, 2021
Comparison of mild and microdose GnRH agonist flare protocols on IVF outcome in poor responders
Mohammad Ali Karimzadeh1, Mehri Mashayekhy, Farnaz Mohammadian
1Department of Obstetrics and Gynecology, Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Bouali Avenue, Safaieh, 8916877391 Yazd, Iran. prof_Karimzade@yahoo.com
Purpose:
To compare the IVF outcome of clomiphene citrate/gonadotropin/antagonist (mild protocol) and microdose GnRH agonist flare protocols for poor responders undergoing in vitro fertilization.
Methods:
159 poor responder patients were randomized and ovarian stimulation was performed with clomiphene citrate, gonadotropin and antagonist (group I) or microdose GnRH agonist flare (group II) protocols. Main outcome was clinical pregnancy rate and secondary outcomes were doses of gonadotropin administration and duration of stimulation.
Results:
There were no significant differences in age, causes of infertility, basal FSH, BMI, duration of infertility, E(2) level on the day of hCG injection in both groups. Although the cancellation, fertilization, and clinical pregnancy rates were similar in both groups, the endometrial thickness, number of retrieved oocytes, mature oocytes and implantation rate were significantly higher in mild protocol. The doses of gonadotropin administration and duration of stimulation were significantly lower in mild protocol.
Conclusion:
We recommend mild protocol in assisted reproductive technology cycles for poor responders based on our results regarding less doses of used gonadotropin and a shorter duration of stimulation.
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