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
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.