Comparing gonadotrophin-releasing hormone agonists or gonadotrophin-releasing hormone antagonists in poor responder in IVF

Objective: The use of GnRH antagonist versus GnRH agonist in poor responder for patient undergoing ovarian hyper-stimulation and in vitro-fertilization was compared. Materials and Methods: In this study, 23 patients underwent ovarian hyperstimulation with recombinant FSH followed by the use of GnRH antagonist (Cetrorelix) 0.25mg during the late Follicular Phase. These patients were compared to 20 patients who underwent controlled ovarian hyper-stimulation with recombinant FSH proceeded by GnRH agonist (short protocol). Results: There was no significant difference between the two groups for mean-age, duration of infertility or base line FSH, number of ampoules of gonadotrophin used, number of mature oocyte retrieved, estradiol concentration on the day of injection of human chronic gonadotrophin HCG, fertilization rate and number of embryo transferred. The clinical pregnancy rate in the antagonist group appear to be high but not significantly different (12% compared to 10%). Conclusion: The addition of GnRH antagonist to ovarian stimulation protocol may be used for poor responder. Further randomized clinical studies with large sample size required to elicit significant differences.