Gonadotropin-releasing Hormone Antagonist Protocol In Poor Responders

Object:To estimate the efficacy of gonadotrophin-releasing hormone antagonist(cetrorelix) utilization in poor responders in controlled ovarian stimulation..Materials and methods: Retrospective analysis 50 patients undergoing IVF with or without ICSI. 24 patients were allocated to the protocol with antagonist and 26 to the agonist protocol. Using SPSS for Windows with a two-sided 5% significance level.Results: The mean (±S.D.) duration of stimulation was 8.5±1.5 days in the antagonist group and 10.5±1.6 days in the agonist group(P<0.001). The mean (±S.D.) duration of suppression was 5.6±1.5days in the antagonist group and 21.5±1.6 days in the agonist group (P < 0.001). The mean (±S.D.) amount of rFSH required was 41.3±12.9 ampoules in the antagonist group and 52.4±16.2 ampoules in the agonist group (P<0.05), The median estradiol level on hCG day was 5234.5 pmol/Lin the antagonist group and 9661.0 pmol/Lin the agonist group (P<0.05), The mean (±S.D.) number of oocytes retrieved was 7.1±3.3 in the antagonist group and 10.3±5.8 in the agonist group (P<0.05).No significant differences were noted in fertilization rate, high quality embryo rate ,implantation rate and clinical pregnancy rate.Conclusion: GnRH-ant protocol are the protocol choice for the treatment of poor responders, the use of GnRH-ant ended with significant less ampoules of gonadotropins and a shorter duration of stimulation and suppression,although the median estradiol level on hCG day and the number of oocytes retrieved was lower,no significant differences were noted in fertilization rate, high quality embryo rate, implantation rate and clinical pregnancy rate.