Document Detail


Poor prognosis for ovarian response to stimulation: results of a randomised trial comparing the flare-up GnRH agonist protocol vs. the antagonist protocol.
MedLine Citation:
PMID:  20196635     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the efficacy of the flare-up agonist and the antagonist protocols in patients with poor prognosis for ovarian response. METHODS: A randomised trial was conducted on two hundred and twenty-one women considered as having poor prognosis for ovarian response to stimulation, based on previous cycles or clinical criteria. All women were prospectively randomised into two groups of treatment (flare-up group and antagonist group) by computer-assisted randomisation in a 1:1 ratio. The main outcome measure was clinical pregnancy rate. RESULTS: Groups were homogeneous in age and baseline characteristics. Duration of stimulation, gonadotropin consumption, number of oocytes retrieved and number and quality of embryos transferred did not differ significantly between the groups. E(2) level the day of hCG administration was significantly higher in the flare-up group. Pregnancy rates per started cycle were 15% in the flare-up group and 14.1% in the antagonist group. Cancellation rates were 12.5% in the flare-up group and 16.3% in the antagonist group. None of these differences reached statistical significance. CONCLUSIONS: No statistically significant differences were observed between the two protocols regarding clinical pregnancy rates. In patients with poor prognosis for ovarian response, the flare-up agonist and the antagonist protocols were comparable regarding clinical pregnancy rates.
Authors:
Marta Devesa; Francisca Martínez; Buenaventura Coroleu; Rosa Tur; Clara González; Ignacio Rodríguez; Pedro N Barri
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology     Volume:  26     ISSN:  1473-0766     ISO Abbreviation:  Gynecol. Endocrinol.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-14     Completed Date:  2010-09-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807913     Medline TA:  Gynecol Endocrinol     Country:  England    
Other Details:
Languages:  eng     Pagination:  509-15     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynaecology, Institut Universitari Dexeus, Barcelona, Spain. mardev@dexeus.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Analysis of Variance
Embryo Transfer
Female
Follicle Stimulating Hormone, beta Subunit / therapeutic use*
Gonadotropin-Releasing Hormone / analogs & derivatives*,  therapeutic use
Hormone Antagonists / therapeutic use
Humans
Infertility, Female / therapy*
Ovulation Induction / methods*
Patient Selection
Pregnancy
Pregnancy Rate
Prospective Studies
Recombinant Proteins / therapeutic use*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Follicle Stimulating Hormone, beta Subunit; 0/Hormone Antagonists; 0/Recombinant Proteins; 123246-29-7/ganirelix; 33515-09-2/Gonadotropin-Releasing Hormone

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