Wednesday, April 13, 2011

Wht is the best protocol for poor responders (diminished ovarian reserve)? A comparison of different protocols for poor responders in IVF: study.


"Poor responders" are women who have a sub optimal response to fertility drugs: they make less eggs than expected after taking fertility medication. This may be due to actual age or to premature ovarian aging.
What is the optimal stimulation protocol for poor responders? For many years people have tried different protocols such as estrogen priing , microdose Lupron , micro hcg , high fgonadotropin , low gonadotropin, clomid plus gonadotropin etc.

A doctor may try to tell you that one protocol is superior to the other but , in fact they are all very similar in outcome.

This recent study on fertility and sterility compares microdose lupron protocol to luteal phase ganarelix(Antagon or Cetrotide). the outcome of the study is no surprise: no difference between the two protocols.

abstract below.

We performed a randomized trial to compare IVF outcomes in 54 poor responder patients undergoing a microdose leuprolide acetate (LA) protocol or a GnRH antagonist protocol incorporating a luteal phase E2 patch and GnRH antagonist in the preceding menstrual cycle. Cancellation rates, number of oocytes retrieved, clinical pregnancy rates (PR), and ongoing PRs were similar between the two groups.

source : fertility and sterility

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