Microdose Flare-up Gonadotropin-releasing Hormone (GnRH) Agonist Protocol and GnRH Antagonist Protocol: Effects on In-vitro Fertilization in Patients with Poor-responder Diagnosis According to Bologna Criteria

Microdose flare-up vs. GnRH antagonist protocols

Authors

  • Gökşen Görgülü University of Health Science, Tepecik Education and Research Hospital, Department of Gynecologic Oncology https://orcid.org/0000-0003-2837-8497
  • Merve Çakır Köle Kocaeli University Faculty of Medicine, Gynecologic Oncology Clinic,Turkey https://orcid.org/0000-0002-9330-3363
  • Oya Aldemir University of Health Sciences, Ankara Etlik Zübeyde Hanım Gynecology and Obstetrics Training and Research Hospital
  • Emre Köle Kocaeli Darica Farabi training and research hospital, Turkey https://orcid.org/0000-0002-4940-8862
  • Serdar Dilbaz University of Health Sciences, Ankara Etlik Zübeyde Hanım Gynecology and Obstetrics Training and Research Hospital

DOI:

https://doi.org/10.46328/aejog.v3i2.84

Keywords:

Infertility, In-vitro fertilization, Gonadotropin-Releasing Hormone Agonists, Gonadotropin-Releasing Hormone Antagonists, Infertility, In Vitro Fertilization Pregnancy

Abstract

Objective: The aim of the study was to evaluate microdose flare-up Gonadotropin-Releasing Hormone (GnRH) agonist protocol and GnRH antagonist protocol with respect to their effects on in-vitro fertilization (IVF) results in patients with poor ovarian response according to the Bologna Criteria.

Material Methods: This was a retrospective cohort study conducted in the Assisted Reproduction clinic of University of Health Sciences, Etlik Zübeyde Hanım Gynaecology Training and Research Hospital. A total of 645 patients who had been diagnosed as poor responders in our clinic, between 2007 and 2018, and received treatment with either microdose flare-up GnRH agonist protocol (n=250, 38.8%) or GnRH antagonist protocol (n=395, 61.2%), were included in the study.

Results: The mean age of the study group was 34.5±5.5 years. Comparisons showed that IVF cycle cancellation frequency (p<0.01), third day estradiol level (p=0.04) and third day follicle stimulating hormone level (p<0.01) were significantly greater in patients who underwent the microdose flare-up protocol. In the GnRH antagonist group, the number of surviving children (p=0.01), antral follicle count (p<0.01), follicle count on day of human chorionic gonadotropin (hCG) administration (p<0.01), endometrial thickness on hCG day (p<0.01), number of oocytes collected (p<0.01), mature oocyte count (p<0.01), embryo transfer number (p<0.01) were higher compared to the microdose flare-up protocol group. The two groups were similar in terms of clinical pregnancy rate.

Conclusions: In terms of clinical pregnancy rate, the IVF results of microdose flare-up and GnRH antagonist protocols are similar. Further studies are needed to reach more comprehensive results on the subject.

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Published

2021-08-23

How to Cite

1.
Görgülü G, Çakır Köle M, Aldemir O, Köle E, Dilbaz S. Microdose Flare-up Gonadotropin-releasing Hormone (GnRH) Agonist Protocol and GnRH Antagonist Protocol: Effects on In-vitro Fertilization in Patients with Poor-responder Diagnosis According to Bologna Criteria: Microdose flare-up vs. GnRH antagonist protocols. Aegean J Obstet Gynecol [Internet]. 2021 Aug. 23 [cited 2021 Sep. 22];3(2):1-5. Available from: https://aejog.com/index.php/aejog/article/view/84