Effect of antagonist start day on cycle outcomes in poor responders
Journal of Human Reproductive Sciences, cilt.14, sa.4, ss.400-405, 2021 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 14 Sayı: 4
- Basım Tarihi: 2021
- Doi Numarası: 10.4103/jhrs.jhrs_75_21
- Dergi Adı: Journal of Human Reproductive Sciences
- Derginin Tarandığı İndeksler: Scopus, Academic Search Premier, CAB Abstracts, EMBASE, Veterinary Science Database, Directory of Open Access Journals
- Sayfa Sayıları: ss.400-405
- Anahtar Kelimeler: Bologna criteria, controlled ovarian stimulation, decreased ovarian reserve, gonadotropin releasing hormone-Antagonist
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Despite the great advances in Assisted Reproductive Technologies (ART), management of poor responders has remained a great challenge. Gonadotropin releasing hormone antagonist (GnRH-Ant) has been offered as a patient friendly protocol. In the literature, conflicting data exists about the effect of the GnRH-Ant starting day on cycle outcomes. Aim: The aim of this study is to evaluate the effect of GnRH-Ant starting day on cycle outcomes of patients with poor ovarian response defined by Bologna criteria. Setting and Design: This retrospective cohort study was conducted at an ART clinic of a tertiary hospital. Materials and Methods: A total of 361 cycles using flexible GnRH-Ant, 195 in Group A (GnRH-Ant administered before day 6 of stimulation) and 166 cycles in Group B (GnRH-Ant started on or after day 6), were selected retrospectively for the study. Statistical analysis: Statistical analysis of data was carried out using using IBM SPSS Statistics Software (20.0, SPSS Inc., Chicago, IL, USA). Independent samples t-Test and Mann-Whitney U test were used to analyze the variables. Results: Total antral follicle count was significantly higher in Group A compared to Group B (P = 0.009). Duration of stimulation was significantly shorter (P < 0.01) and total dose of gonadotropin used was lower in Group A when compared to Group B (P < 0.01). While higher number of oocytes was retrieved from Group A (P = 0.037), no between-group differences were observed in number of mature oocytes, fertilized oocytes, clinical pregnancy rate or ongoing pregnancy rate (OPR) per embryo transfer (P > 0.05). Conclusion: Early GnRH-Ant start may point out a favourable response to ovarian stimulation in poor responders. However, clinical or OPRs were not different from the late GnRH-Ant start group.