Female Infertility Clinical Trial
Official title:
Long Acting FSH Plus GnRH Antagonist Versus Daily FSH Plus GnRH Antagonist Versus Short Agonist Regimens in Poor Responder Patients Undergoing IVF: a Randomized Study.
Despite the progression in assisted reproductive technology (ART), poor ovarian response to
controlled ovarian stimulation remains a challenge for clinicians and a source of distress
for patients. Multiple strategies have been tried to overcome these obstacles. The increase
of the gonadotropin administration have been associated with a very low pregnancy rate. The
introduction of GnRH agonist protocol, which takes advantage of the initial rise in
endogenous gonadotropins that follows the agonist administration in the early follicular
phase and subsequently prevents a premature LH surge, with fewer cycle cancellations, have
improved cycle parameters and increased pregnancy rate. Recently, GnRH antagonists were
introduced in ART treatment. They are effective in preventing a premature LH surge and allow
for a more natural recruitment of follicles in the follicular phase in a non suppressed
ovary. However, the randomized studies comparing the efficacy of these two regimens reported
conflicting and nonsignificant results. Moreover, more recently adjuvant therapies for COH
such as growth hormone therapy or pyridostigmine, oral L-arginine, and transdermal
testosterone failed to improve IVF outcomes. Recently, the new treatment option with
corifollitropin alfa, able to keep the circulating FSH level above the threshold necessary
to support multi-follicular growth for an entire week, in a GnRH antagonist protocol seems
to have a potential beneficial effect in poor responders.
The aim of this study is to compare long-acting FSH/GnRH antagonist with daily FSH/GnRH
antagonist with short GnRH agonist protocol on IVF outcome in poor responder patients .
n/a
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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