A comparison of treatment results of the different treatment protocols in patients with poor ovarian response

Abstract

To compare the effect of the different protocols in patients receiving in vitro fertilization treatment due to poor ovarian response. Seventy-seven of the patients included in the study were treated with gonadotropin (450 IU) + GnRH antagonist (group 1), 84 of the patients were treated with gonadotropin (450 IU) + microdose GnRH analog (group 2), and 53 of the patients were treated with clomiphene citrate (100 mg/day) + gonadotropin (300 IU) + GnRH antagonist (Group 3). In assessing total gonadotropin dosage, patients in Group 3 detected significantly less gonadotropin as compared to the other two groups (p < .001). Group 1 were superior to the other two groups with respect to retrieved oocytes, meiosis II oocytes and number of embryos obtained at the end of the treatment. As for the evaluation of clinical pregnancy, although the highest pregnancy rate was in Group 3, this finding was not of statistical significance. Although increasing the dosage of gonadotropins for ovarian hyper stimulation treatment in patients with poor ovarian response is beneficial with respect to retrieved oocytes, meiosis II oocytes and number of embryos, the increased dosage does not provide a statistically significant increase in clinical pregnancy rates.

Chinese abstract

研究目的是比较不同治疗方案对体外受精卵巢反应低下患者的治疗效果。研究对象分为三组：第1组为77名患者应用促性腺激素（450 IU）+ GnRH拮抗剂治疗, 第2组为84名患者应用促性腺激素（450 IU）治疗+小剂量GnRH类似物治疗, 第3组为53名患者接受枸橼酸克罗米酚（100 毫克/天）+促性腺激素（300 IU）+ GnRH拮抗剂治疗。在评估总促性腺激素剂量时, 与其他两组相比, 第3组患者检测到的促性腺激素明显减少（p < .001）。第1组检索到的卵母细胞数, 减数分裂II期的卵母细胞数和治疗结束时获得的胚胎数目高于其他两组。至于临床妊娠评估, 虽然第3组怀孕率最高, 但这一发现并无统计学意义。卵巢反应低下患者在进行超促排治疗时, 虽然增加促性腺激素剂量有利于检测到的获卵数, 减数分裂II期卵母细胞数和获得胚胎数目的增加, 但是增加的剂量没有明显提高临床妊娠率。

Keywords:

• Poor responder
• poor ovarian response
• GnRH agonist protocol
• GnRH antagonist protocol
• clomiphene citrate

Disclosure statement

The authors have stated explicitly that there are no with this any financial support or relationships that may pose potential conflict of interest in this article.