MINIDOSE GONADOTROPIN-RELEASING-HORMONE AGONIST IS THE TREATMENT OF CHOICE IN POOR RESPONDERS WITH HIGH FOLLICLE-STIMULATING-HORMONE LEVELS

Objective: To investigate the effectiveness of minidose GnRH agonist ( GnRH-a) + hMG in poor responders with elevated basal level FSH. Design : Restrospective analysis of IVF cycles. Setting: IVF Unit, Golda Medi cal Center, Petah Tikva, Israel. Patients: One hundred six patients wh o were defined as poor responders on two previous IVF attempts. Three treatment protocols of midluteal Decapeptyl (D-Trp(6)) were compared: [1] a single-dose of 3.75 mg; [2] 0.5 mg daily until menstruation, fol lowed by 0.1 mg daily; and [3] 0.1 mg daily until menstruation, follow ed by 0.05 mg daily. Main Outcome Measures: Comparisons were made amon g the three protocols regarding basal FSH levels, number of oocytes re trieved and fertilized, number of days of stimulation, follicular phas e, P levels, and pregnancy and miscarriage rates. Results: Treatment w ith minidose GnRH-a resulted in higher E, levels and lower P levels on the day of hCG and lower cancellation rates. Furthermore, a higher nu mber of oocytes recovered and fertilized and embryos transferred were recorded. The trend indicated improved pregnancy and implantation rate s with a lower miscarriage rate. Conclusion: Minidose GnRH-a is a bett er choice than regular GnRH-a strategies in poor-responder patients un dergoing IVF treatment.