[Revisiting GnRH analog protocols II. Strategy for poor responders]

Area of Science:

• Reproductive endocrinology
• In vitro fertilization (IVF) protocols
• Hormonal regulation in assisted reproduction

Context:

• Ovarian hyperstimulation protocols are crucial for IVF success.
• Gonadotropin-releasing hormone (GnRH) analogs are widely used in these protocols.
• Understanding the nuanced effects of GnRH analogs is essential for optimizing IVF outcomes, particularly in challenging cases.

Purpose:

• To review and analyze the diverse protocols for ovarian hyperstimulation using GnRH analogs in IVF.
• To evaluate the beneficial and adverse effects of GnRH analogs on IVF cycle outcomes.
• To inform strategies for managing poor responders undergoing IVF treatment with GnRH analogs.

Summary:

• GnRH analogs offer benefits like preventing LH surges and premature luteinization during ovarian hyperstimulation for IVF.
• However, potential adverse effects include increased gonadotropin requirements and negative impacts on ovarian function and conceptus quality.
• The diverse mechanisms and outcomes necessitate careful consideration, especially for poor responders, and warrant evaluation of trends towards reduced GnRH analog doses.

Impact:

• Provides a critical overview of GnRH analog protocols in IVF, highlighting areas of uncertainty.
• Guides clinicians in developing tailored strategies for poor responders to improve IVF success rates.
• Contributes to the ongoing refinement of assisted reproductive technology protocols for better patient outcomes.