Fertility and Sterility
Volume 93, Issue 2 , Pages 360-363 , 15 January 2010

A comparison of gonadotropin-releasing hormone (GnRH) antagonist and GnRH agonist flare protocols for poor responders undergoing in vitro fertilization

Presented at the 4th Annual Meeting of the New England Fertility Society, Newport, Rhode Island, April 7–8, 2006.

  • Inna Berin, M.D.
    • ,
  • Daniel E. Stein, M.D.
    • ,
  • Martin D. Keltz, M.D.

      Affiliations

    • Corresponding Author InformationReprint requests: Martin D. Keltz, M.D., Director, Division of Reproductive Endocrinology and Infertility, Department of OB/GYN, St. Luke's-Roosevelt Hospital Center, 1000 10th Avenue, New York, New York 10019 (FAX: 212-523-8348).

Received 15 September 2008 ,Revised 15 October 2008 ,Accepted 4 November 2008.

References 

  1. Droesch K, Muasher S, Brzyski R, Jones G, Simonetti S, Liu H, et al. Value of suppression with a gonadotropin-releasing hormone agonist prior to gonadotropin stimulation for in vitro fertilization. Fertil Steril. 1989;51:292–297
  2. Serafini P, Stone B, Kerin J, Batzofin J, Quinn P, Marrs R. An alternate approach to controlled ovarian hyperstimulation in “poor responders”: pretreatment with a gonadotropin-releasing hormone analog. Fertil Steril. 1988;49:90–95
  3. Muasher SJ. Controversies in assisted reproduction: treatment of low responders. J Assist Reprod Genet. 1993;10:112–114
  4. Feldberg D, Farhi J, Ashkenazi J, Dicker D, Shalev J, Ben Rafael Z. Minidose gonadotropin releasing hormone agonist is the treatment choice in poor responders with high follicle-stimulating hormone levels. Fertil Steril. 1994;62:343–346
  5. Horvath P, Styler M, Hammond J, Shelden R, Kemmann E. Exogenous gonadotropin requirements are increased in leuprolide suppressed women undergoing ovarian stimulation. Fertil Steril. 1988;49:159–162
  6. Confino E, Zhang X, Kazer R. GnRHa flare and IVF pregnancy rates. Int J Gynaecol Obstet. 2004;85:36–39
  7. Toth T, Awwad J, Veeck L, Jones H, Muasher S. Suppression and flare regimens of gonadotropin-releasing hormone agonist. J Reprod Med. 1996;41:321–326
  8. Padilla S, Dugan K, Maruschak V, Shalika S, Smith R. Use of the flare-up protocol with high dose human follicle stimulating hormone and human menopausal gonadotropins for in vitro fertilization in poor responders. Fertil Steril. 1996;65:796–799
  9. Fasoulitis S, Laufer N, Sabbagh-Ehrlich S, Lewin A, Hurwitz A, Simon A. Gonadotropin-releasing hormone (GnRH)-antagonist versus GnRH-agonist in ovarian stimulation of poor responders undergoing IVF. J Assist Reprod Genet. 2003;20:455–460
  10. Akman M, Erden H, Tosun S, Bayazit N, Aksoy E, Bahceci M. Comparison of agonistic flare-up-protocol and antagonistic multiple dose protocol in ovarian stimulation of poor responders: results of a prospective randomized trial. Hum Reprod. 2001;16:868–870
  11. Karande V, Morris R, Rinehart J, Miller C, Rao R, Gleicher N. Limited success using the “flare” protocol in poor responders in cycles with low basal follicle-stimulating hormone levels during in vitro fertilization. Fertil Steril. 1997;67:900–903
  12. Leonidris M, Escalpes M, Segars J, Scott R, Miller B. Microdose follicular phase gonadotropin-releasing hormone agonists (GnRH-a) compared with luteal phase GnRH-a for ovarian stimulation at in vitro fertilization. Fertil Steril. 1999;72:1018–1023
  13. Surrey E, Bower J, Hill D, Ramsey J, Surrey M. Clinical and endocrine effects of a microdose GnRH agonist flare regimen administered to poor responders who are undergoing in vitro fertilization. Fertil Steril. 1998;69:419–424
  14. Mohamed K, Davies W, Allsopp J, Lashen H. Agonist “flare-up” versus antagonist in the management of poor responders undergoing in vitro fertilization treatment. Fertil Steril. 2005;83:331–335
  15. Schmidt D, Bremner T, Orris J, Maier D, Benadiva C, Nulsen J. A randomized prospective study of microdose leuprolide versus ganirelix in in vitro fertilization cycles for poor responders. Fertil Steril. 2005;83:1568–1571
  16. Akman M, Erden H, Tosun S, Bayazit N, Aksoy E, Bahceci M. Addition of GnRH-antagonist in cycles of poor responders undergoing IVF. Hum Reprod. 2000;15:2145–2147
  17. Nikolettos N, Al-Hasani S, Felberbaum R, Demirel LC, Kupker W, Montzka P, et al. Gonadotropin-releasing hormone antagonist protocol: a novel method of ovarian stimulation in poor responders. Eur J Obstet Gynecol Reprod Biol. 2001;97:202–207
  18. Olivennes F, Balaisch-Allart J, Emperaire JC, Dechaud H, Alvarez S, Moreau L, et al. Prospective, randomized, controlled study of in vitro fertilization-embryo transfer with a single dose of a luteinizing hormone-releasing hormone (LH-RH) antagonist (cetrorelix) or a depot formulation of an LH-RH agonist (triptorelin). Fertil Steril. 2000;73:314–320

 I.B. has nothing to disclose. D.E.S. has nothing to disclose. M.D.K. has nothing to disclose.

PII: S0015-0282(08)04550-0

doi: 10.1016/j.fertnstert.2008.11.007

Fertility and Sterility
Volume 93, Issue 2 , Pages 360-363 , 15 January 2010

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