alexa Ultrashort Flare GnRH Agonist with GnRH Antagonist (MDA
ISSN: 2375-4508

Journal of Fertilization: In Vitro - IVF-Worldwide, Reproductive Medicine, Genetics & Stem Cell Biology
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Research Article

Ultrashort Flare GnRH Agonist with GnRH Antagonist (MDA/Ant) Protocol Compared with Clomiphene Citrate/ Gonadotropins (CC/GND) for Poor Responder Patients

Carolina M Sueldo, Lawrence Engmann, Leah Kaye, Daniel Griffin, John Nulsen and Claudio Benadiva*
Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Connecticut Health Center, 2 Batterson Park Rd, Farmington CT 06032, United States
*Corresponding Author : Claudio Benadiva
The Center for Advanced Reproductive services
2 Batterson Park Rd
Farmington CT 06032
United States
Fax: 860-471-8971
E-mail: [email protected]
Received March 28, 2016; Accepted April 16, 2016; Published April 23, 2016
Citation: Sueldo CM, Engmann L, Kaye L, Griffin D, Nulsen J, et al. (2016) Ultrashort Flare GnRH Agonist with GnRH Antagonist (MDA/Ant) Protocol Compared with Clomiphene Citrate/ Gonadotropins (CC/GND) for Poor Responder Patients. J Fertil In Vitro IVF Worldw Reprod Med Genet Stem Cell Biol 4:179. doi:10.4172/2375-4508.1000179
Copyright: © 2016 Sueldo CM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Background: The ultrashort flare GnRH agonist/ GnRH antagonist protocol (MDA/Ant) has recently been advocated as a useful option for poor ovarian response (POR). POR patients with repeated IVF failures were offered stimulation with MDA/Ant (Group 1) or clomiphene citrate/gonadotropins (CC/Gnd; Group 2).

Objective: The aim of this study was to compare Group 1 versus Group 2 in a POR population, from January 1st, 2010 until October 1st, 2014.

Design: Retrospective Cohort Analysis.

Methods: A total of 116 IVF cycles were included in the study. Group 1 received 21 days of oral contraceptives (OCP’s), and were then treated with leuprolide acetate 40 mcg twice a day for the first 3 days, followed by high dose gonadotropins with a flexible start Gonadotropin Releasing Hormone (GnRH) antagonist. Group 2 received CC 100mg x 5 days, and on CC day 4 rec-FSH 600 IU was added.

Results: No differences were found in age, body mass index (BMI), day 3 follicle stimulating hormone (FSH), or previous number of failed cycles. There were no differences noted in clinical pregnancy rate or live birth rate. Group 2 required a significantly lower amount of total gonadotropins, but Group 1 had a significantly lower rate of cycle cancellation.

Conclusions: Although a higher dose of gonadotropins was required, the significantly lower cancellation rate when compared with Group 2 suggests that the MDA/Ant regimen may be a useful alternative protocol for poor responder patients.


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