Pregnancy outcome of “delayed start” GnRH antagonist protocol versus GnRH antagonist protocol in poor responders: A clinical trial study|
Aflatoonian, Abbas; Hosseinisadat, Robabe; Baradaran, Ramesh & Mojtahedi, Maryam Farid
Background: Management of poor-responding patients is still major challenge in
assisted reproductive techniques (ART). Delayed-start GnRH antagonist protocol is
recommended to these patients, but little is known in this regards.
Objective: The goal of this study was assessment of delayed-start GnRH antagonist
protocol in poor responders, and in vitro fertilization (IVF) outcomes.
Materials and Methods: This randomized clinical trial included sixty infertile
women with Bologna criteria for ovarian poor responders who were candidate for
IVF. In case group (n=30), delayed-start GnRH antagonist protocol administered
estrogen priming followed by early follicular-phase GnRH antagonist treatment for
7 days before ovarian stimulation with gonadotropin. Control group (n=30) treated
with estrogen priming antagonist protocol. Finally, endometrial thickness, the rates
of oocytes maturation, embryo formation, and pregnancy were compared between
Results: Rates of implantation, chemical, clinical, and ongoing pregnancy in
delayed-start cycles were higher although was not statistically significant.
Endometrial thickness was significantly higher in case group. There were no
statistically significant differences in the rates of oocyte maturation, embryo
formation, and IVF outcomes between two groups.
Conclusion: There is no significant difference between delayed-start GnRH
antagonist protocol versus GnRH antagonist protocol.
Pregnancy outcome; Poor responder; In vitro fertilization; GnRH antagonist protocol