IVF Research Today is a free monthly online journal that collates and summarizes the latest research about IVF, including details on in vitro fertilization, infertility, treatment, procedure, pregnancy, success rates. | ||||||||
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Agonist "flare-up" versus antagonist in the management of poor responders undergoing in vitro fertilization treatment.Mohamed KA, Davies WA, Allsopp J, Lashen H CARE at the Three Shires Hospital, Northampton, UK. kamel.mohamed@ntlworld.com OBJECTIVE: To compare the agonist flare-up and antagonist protocols in the management of poor responders to the standard long down-regulation protocol. DESIGN: Retrospective comparative study. SETTING: Assisted conception center. PATIENT(S): One hundred thirty-four patients undergoing IVF/ intracytoplasmic sperm injection (ICSI) treatment, who responded poorly to the standard long down-regulation protocol in their first treatment cycle. In the second cycle, 77 received short flare-up agonist and 57 received antagonist protocol. We analyzed the outcome of the second cycle. INTERVENTION(S): Peak serum E(2) was assayed on the day of hCG administration. MAIN OUTCOME MEASURE(S): Cycle cancellation rate due to poor ovarian response. RESULT(S): There was no cycle cancellation in the flare-up protocol and 7% cancellation rate in the antagonist protocol due to lack of response. A significantly higher number of patients had embryo transfer in the flare-up protocol. There was no difference in pregnancy rate (PR) between the two groups. CONCLUSION(S): Both the flare-up and the antagonist protocols significantly improved the ovarian response of known poor responders. However, a significantly higher cycle cancellation rate and less patients having embryo transfer in the antagonist group tips the balance in favor of the flare-up protocol. Published 11 February 2005 in Fertil Steril, 83(2): 331-5.
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