A Comparison of 3 Different Controlled Ovarian Stimulation Protocols in Poor Women Responders Chosen According to POSEIDON Criteria: Micro-dose, Standard Flare-up, and Antagonist Protocol

IF 0.8 Q4 REPRODUCTIVE BIOLOGY
M. M. Al-Jeborry, Fadia J Alizzi, Lubna A Al-Anbari
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Abstract

Objectives: To compare the effectiveness and outcomes of pregnancy accomplished by in vitro fertilization between micro-dose and standard flare-up, along with antagonist protocols in the treatment of poor responders using POSEIDON (Patient-Oriented Strategies Encompassing Individualized Oocyte Number) criteria for diagnosis. Materials and Methods: This prospective study included 114 poor responder Iraqi women undergoing intracytoplasmic sperm injection (ICSI) cycles, who were randomly allocated to 3 groups according to the treatment protocol. Micro-dose (n=38), standard flare-up (n=38) and antagonist (n=38) protocols. High dose gonadotrophins (300-450 IU/day) from day 2 of the cycle until the day of human chorionic gonadotropin (hCG) administration were used in the three groups. The primary outcome measure was the number of retrieved mature oocytes and the secondary outcomes included fertilization, implantation, and pregnancy rates (PRs). Results: The estradiol level at the day of hCG trigger was higher in women who received a standard flare-up protocol while there was a higher endometrial thickness in the micro-dose group compared to standard flare-up and antagonist groups (P<0.05). In addition, non-statistically significantly higher fertilization, implantation, and PRs with less cancellation rates were observed in the micro-dose group. Conclusions: The micro-dose protocol in the poor responder improved pregnancy, fertilization, and implantation rates while reducing the cancellation rate compared to standard flare-up and antagonist protocols although the result represented no statistical significance.
根据POSEIDON标准选择3种不同的对照卵巢刺激方案:微剂量、标准发作和拮抗剂方案
目的:比较微剂量和标准急性发作的体外受精妊娠的疗效和结果,以及使用POSEIDON(以患者为导向的策略,包括个体化卵母细胞数量)诊断标准治疗不良反应的拮抗剂方案。材料与方法:本前瞻性研究纳入114名接受卵胞浆内单精子注射(ICSI)周期治疗的反应不良的伊拉克妇女,根据治疗方案随机分为3组。微剂量(n=38)、标准急性发作(n=38)和拮抗剂(n=38)方案。三组从周期第2天至人绒毛膜促性腺激素(hCG)给药当天使用高剂量促性腺激素(300-450 IU/天)。主要结局指标是取出成熟卵母细胞的数量,次要结局包括受精、着床和妊娠率(pr)。结果:与标准急性发作组和拮抗剂组相比,接受标准急性发作方案的妇女在hCG触发当天的雌二醇水平较高,而微剂量组子宫内膜厚度较高(P<0.05)。此外,微剂量组的受精率、着床率和消去率均较高,且无统计学意义。结论:与标准的急性发作和拮抗剂方案相比,微剂量方案改善了不良反应患者的妊娠、受精和着床率,同时降低了取消率,尽管结果没有统计学意义。
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来源期刊
CiteScore
1.60
自引率
14.30%
发文量
8
期刊介绍: All kind of knowledge contributing to the development of science by its content, value, level and originality will be covered by IJWHR. Problems of public health and their solutions are at the head of the windows opening us to the world. The "International Journal of Women''s Health and Reproduction Sciences” is a modern forum for scientific communication, covering all aspects women health and reproduction sciences, in basic and clinical sciences, mainly including: -Medical Education in Women Health and Reproduction Sciences -Cardiology in Women Health-Related Reproductive Problems -Sports Medicine in Women Health and Reproduction Sciences -Psychiatry in Women Health-Related Reproductive Problems -Antioxidant Therapy in Reproduction Medicine Sciences -Nutrition in Women Health and Reproduction Sciences -Defense Androgen and Estrogen -Fertility and Infertility -Urogynecology -Endometriosis -Endocrinology -Breast Cancer -Menopause -Puberty -Eroticism -Pregnancy -Preterm Birth -Vaginal Diseases -Sex-Based Biology -Surgical Procedures -Nursing in Pregnancy -Obstetrics/Gynecology -Polycystic Ovary Syndrome -Hyperandrogenism in Females -Menstrual Syndrome and Complications -Oncology of Female Reproductive Organs -Traditional Medicine in Women Reproductive Health -Ultrasound in Women Health Reproduction sciences -Stem Cell Research In Women Reproduction Sciences -Complementary Medicine in Women Reproductive Health -Female Sexual Dysfunction: Pathophysiology & Treatment
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