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Gnrh Agonist Stop-Antagonist Protocol Versus the Gnrh Antagonist Protocol in Patients With Poor Ovarian Response Undergoing Ivf; [Protocolo Stop-Antagonista Del Agonista De Gnrh Versus Protocolo De Antagonista De Gnrh En Pacientes Con Pobre Respuesta De Ovarica Sometidos a Fiv] Publisher



Khezri A1, 6 ; Kashani L2 ; Moini A3, 4, 5 ; Mojtahedi MF1, 6 ; Yamini N7 ; Ataee M8, 9
Authors
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Authors Affiliations
  1. 1. Infertility Ward Arash Women‘s Hospital, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Infertility center of arash hospital, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
  4. 4. Breast Disease Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Obstetrics and Gynecology, Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Infertility Ward Arash Women‘s Hospital, Tehran University of Medical Sciences, Tehran, Iran
  7. 7. IVF Laboratory, Department of ART, Arash Women‘s Hospital, Tehran University of Medical Science, Tehran, Iran
  8. 8. Department of Obstetrics and Gynecology, Social Determinants of Health, Research Center School of Medical Sciences, Alborz University of Medical Sciences, Karaj, Iran
  9. 9. Reproductive Biotechnology Research Center, Avicenna Research Institute ACECR, Tehran, Iran

Source: Revista Latinoamericana de Hipertension Published:2022


Abstract

Introduction and objective: Can theGnRH agonist STOPantagonist protocol versus the GnRH antagonist protocol be useful in improving IVF (In vitro fertilization) outcomes in patients with poor ovarian responses candidate for IVF? Methods: The present study was conducted as a singleblind clinical trial in the infertility ward of Arash Hospital of Tehran University of Medical Sciences. In this study, 133 patients with poor ovarian response (POR) according to Bologna criteria were randomly assigned two groups of GnRH agonist stop-antagonist protocol and GnRH antagonist protocol. The number of dominant follicles and number of oocytes retrieved, the number of embryos and their grade, level of antagonist used, level of gonadotropin used, length of days of stimulation and endometrial thickness, level of estrogen, level of progesterone, trigger day, and fertilization rate were measured. Results: In the present study, the frequency of dominant follicles in the GnRH agonist stop-antagonist group was significantly higher than that in the GnRH antagonist group (p-value = 0.01). The number of embryos in the GnRH agonist stop_antagonist group was significantly higher than that in the GnRH antagonist group (p-value = 0.02). The percentage of AB embryo agonists in the GnRH agonist stop _anta group was significantly higher than that in the GnRH antagonist group (p-value = 0.003). The number of mature oocytes in the GnRH agonist stop _antagonist group was more than that in the GnRH antagonist group, but the difference between the two groups was not statistically significant. The number of used gonadotropin doses in the GnRH agonist stop _antagonist group was significantly higher than that in the GnRH antagonist group (p-value = 0.01). The number of used antagonists in the GnRH antagonist group was significantly higher than that in the GnRH agonist stop _antagonist group (p-value = 0.02). Conclusion: The GnRH agonist stop-Anta protocol is a valuable tool for the treatment of poor ovarian responders. However, controlled prospective randomized studies with larger sample sizes are needed. © 2022, Venezuelan Society of Pharmacology and Clinical and Therapeutic Pharmacology. All rights reserved.