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KMID : 1033620110380040228
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Clinical and Experimental Reproductive Medicine
2011 Volume.38 No. 4 p.228 ~ p.233
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GnRH antagonist multiple dose protocol with oral contraceptive pill pretreatment in poor responders undergoing IVF/ICSI
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Kim Chung-Hoon
You Rae-Mi
Kang Hyuk-Jae
Ahn Jun-Woo
Jeon Il-Kyung
Lee Ji-Won
Kim Sung-Hoon
Chae Hee-Dong
Kang Byung-Moon
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Abstract
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Objective: To investigate the effectiveness of GnRH antagonist multiple-dose protocol (MDP) with oral contraceptive pill (OCP) pretreatment in poor responders undergoing IVF/ICSI, compared with GnRH antagonist MDP without OCP pretreatment and GnRH agonist low-dose long protocol (LP).
Methods: A total of 120 poor responders were randomized into three groups according to controlled ovarian stimulation (COS) options; GnRH antagonist MDP after OCP pretreatment (group 1), GnRH antagonist MDP without OCP pretreatment (group 2) or GnRH agonist luteal low-dose LP without OCP pretreatment (group 3). Patients allocated in group 1 were pretreated with OCP for 21days in the cycle preceding COS, and ovarian stimulation using recombinant human FSH (rhFSH) was started 5 days after discontinuation of OCP.
Results: There were no differences in patients’ characteristics among three groups. Total dose and days of rhFSH used for COS were significantly higher in group 3 than in group 1 or 2. The numbers of mature oocytes, fertilized oocytes and grade I, II embryos were significantly lower in group 2 than in group 1 or 3. There were no significant differences in the clinical pregnancy rate and implantation rate among three groups.
Conclusion: GnRH antagonist MDP with OCP pretreatment is at least as effective as GnRH agonist low-dose LP in poor responders and can benefit the poor responders by reducing the amount and duration of FSH required for follicular maturation.
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KEYWORD
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Gonadotropin-releasing hormone, Antagonist, Agonist, Oral Contraceptives, Poor Responders, In vitro fertilization, Intracytoplasmic sperm injection, Human
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