Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

Strategies for Pituitary Down-regulation to Optimize IVF/ICSI Outcome in Poor Ovarian Responders

Authors
Ahmed Badawy
Alaa Wageah
Mohamed EL-Gharib
Ezz Eldin Osman
College of Medicine, Al-Jouf University, Mansoura, Egypt
Abstract
The ovarian stimulation of poor responders still remains a challenging task for clinicians. There are numerous strategies that have been suggested to improve the outcome in poor responders but there is still no one pituitary down-regulation protocol that best suits all women with such condition. Traditional GnRH agonist flare and long luteal phase protocols do not appear to be advantageous. Reduction of GnRH agonist doses, "stop" protocols, and microdose GnRH agonist flare regimes all appear to improve outcomes, although the proportional benefit of one approach over another has not been convincingly established. GnRH antagonists improve outcomes in this patient population, although, in general, pregnancy rates appear to be lower in comparison to microdose GnRH agonist flare regimes.
Keywords
ICSI
IVF
Poor ovarian response
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Journal of Reproduction & Infertility
Volume 13, Issue 3
Summer 2012
Pages 124-130