A Novel Stimulation Protocol for Poor-Responder Patients: Combining the Stop GnRH-ag Protocol with Letrozole Priming and Multiple-Dose GnRH-ant: A Proof of Concept.


Journal

Gynecologic and obstetric investigation
ISSN: 1423-002X
Titre abrégé: Gynecol Obstet Invest
Pays: Switzerland
ID NLM: 7900587

Informations de publication

Date de publication:
2021
Historique:
received: 29 10 2020
accepted: 10 12 2020
pubmed: 25 3 2021
medline: 29 6 2021
entrez: 24 3 2021
Statut: ppublish

Résumé

The objective of this study was to examine whether the combined Stop GnRH-agonist (GnRH-ag), letrozole priming, and multiple-dose GnRH-antagonist (GnRH-ant) protocol may improve in vitro fertilization/intracytoplasmic sperm injection cycle in poor ovarian responders (PORs). This was a historical cohort, proof of concept study under tertiary setting at University affiliated Medical Center. Five PORs fulfilling the POSEIDON Group 4 criteria were included. Number of oocytes retrieved, number of top-quality embryos (TQEs), and controlled ovarian hyperstimulation (COH) variables were the main outcome measures. The combined Stop GnRH-ag, letrozole priming, and multiple-dose GnRH-ant COH protocol revealed significantly higher number of follicles >13 mm on the day of hCG administration and higher number of oocytes retrieved, with non-significantly more TQEs and a reasonable clinical pregnancy rate. The combined Stop GnRH-ag, letrozole priming, and multiple-dose GnRH-ant COH protocol is a valuable tool in the armamentarium for treating POSEIDON Group 4 patients. Further large prospective studies are needed to elucidate its role in POR and to identify the specific characteristics of women (before initiating ovarian stimulation) that will aid both fertility specialists' counseling and their patients in adjusting the appropriate COH protocol.

Identifiants

pubmed: 33761501
pii: 000513669
doi: 10.1159/000513669
doi:

Substances chimiques

Aromatase Inhibitors 0
Chorionic Gonadotropin 0
Hormone Antagonists 0
Gonadotropin-Releasing Hormone 33515-09-2
Silver 3M4G523W1G
Letrozole 7LKK855W8I

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

149-154

Informations de copyright

© 2021 S. Karger AG, Basel.

Auteurs

Raoul Orvieto (R)

Department of Obstetrics and Gynecology, Infertility and IVF Unit, Chaim Sheba Medical Center, Tel Hashomer, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, raoul.orvieto@sheba.health.gov.il.
The Tarnesby-Tarnowski Chair for Family Planning and Fertility Regulation, at the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel, raoul.orvieto@sheba.health.gov.il.

Ravit Nahum (R)

Department of Obstetrics and Gynecology, Infertility and IVF Unit, Chaim Sheba Medical Center, Tel Hashomer, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Adva Aizer (A)

Department of Obstetrics and Gynecology, Infertility and IVF Unit, Chaim Sheba Medical Center, Tel Hashomer, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Jigal Haas (J)

Department of Obstetrics and Gynecology, Infertility and IVF Unit, Chaim Sheba Medical Center, Tel Hashomer, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Michal Kirshenbaum (M)

Department of Obstetrics and Gynecology, Infertility and IVF Unit, Chaim Sheba Medical Center, Tel Hashomer, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

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