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Randomized controlled trial of gonadotropin‐releasing hormone agonist microdose flare‐up versus flare‐up among poor responders undergoing intracytoplasmic sperm injection
Author(s) -
Ghaffari Firouzeh,
Jahangiri Nadia,
Madani Tahereh,
Khodabakhshi Shabnam,
Chehrazi Mohammad
Publication year - 2020
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12988
Subject(s) - microdose , medicine , intracytoplasmic sperm injection , gonadotropin releasing hormone agonist , flare , in vitro fertilisation , live birth , randomized controlled trial , gynecology , andrology , gonadotropin releasing hormone , hormone , pregnancy , luteinizing hormone , biology , physics , astrophysics , genetics
Objective To compare the effect of gonadotropin‐releasing hormone (Gn RH ) agonist microdose flare‐up and Gn RH agonist flare‐up protocols among women with poor ovarian reserve undergoing intracytoplasmic sperm injection ( ICSI ) cycles. Methods Randomized controlled trial study among 131 women with poor ovarian reserve who underwent ICSI cycles at a single center in Tehran, Iran, between September 2008 and May 2014. Eligible women were randomly assigned to either the microdose flare‐up (n=66) or flare‐up (n=65) protocol. The primary outcome measure was live birth rate. Results Both groups were comparable in cycle cancellation, mean number of dominant follicles, retrieved oocytes, and metaphase II oocytes. Number of stimulation days ( P =032) and endometrial thickness ( P =0.001) were significantly higher, and gonadotropin dose was non‐significantly higher ( P =0.075) in the microdose flare‐up group than in the flare‐up group. No difference in clinical pregnancy, implantation, or abortion rate was observed between the two protocols. Live birth was higher in the microdose flare‐up group than in the flare‐up group ( P =0.036). Conclusion The microdose flare‐up protocol seemed to be superior to the flare‐up protocol, but it required a higher dose of gonadotropins and a longer duration of stimulation. Further prospective clinical trials of the microdose flare‐up protocol are recommended. ClinicalTrials.gov NCT01006954