CONTROLLED OVARIAN STIMULATION LEADS TO GLANDULAR-STROMAL DYSSYNCHRONY AND DECREASED STROMAL PROLIFERATION IN GOOD RESPONDERS BUT NOT IN POOR RESPONDERS

The objective: сomparative characteristics of patients – poor responders and egg donors with the study of the effectiveness of corypholitropin-α in the schemes of controlled ovarian stimulation with GnRH antagonists protocols. Materials and methods. The analysis of the main clinical characteristics of the patients in the selected groups, age category, social status, level of education, structure of motivations for participation in ART programs, etc., was carried out. The effectiveness of the scheme of controlled ovarian stimulation using prolonged FSH in the protocol with antGNRH was analyzed in comparison with the daily injections of recombinant FSH into the controlled ovarian stimulation programs in egg donors. Results. A statistically significant difference was found in the age of the patients in the selected groups, differences in social status, level of education, etc. It has been proven that ovarian stimulation with corypholitropin-α is as effective as daily injection of recombinant FSH for controlled ovarian stimulation from egg donors. In addition, patient perception of protocols using сorifollitropina-α proves better tolerability compared to traditional protocols, due to fewer injections, which reduces the likelihood of early termination of treatment. Conclusion. The use of prolonged-action FSH has the same efficacy as the traditional protocols of controlled ovarian stimulation in terms of the number of oocytes and embryos obtained, as well as the frequency of pregnancy per cycle and transfer, but at the same time demonstrates a statistically lower dose of FSH. Key words: poor responders, egg donors, controlled ovarian stimulation, corypholitropin-α.

Download Full-text

Conventional Controlled Ovarian Stimulation Protocols for Diminished Ovarian Reserve Patients and Poor Responders

Diminished Ovarian Reserve and Assisted Reproductive Technologies ◽

10.1007/978-3-030-23235-1_8 ◽

2019 ◽

pp. 119-129

Author(s):

Bala Bhagavath

Keyword(s):

Ovarian Reserve ◽

Ovarian Stimulation ◽

Diminished Ovarian Reserve ◽

Controlled Ovarian Stimulation ◽

Poor Responders

Download Full-text

Use of androgens and aromatase inhibitors in poor responders undergoing in vitro fertilization

Journal of obstetrics and women s diseases ◽

10.17816/jowd68637-46 ◽

2020 ◽

Vol 68 (6) ◽

pp. 37-46

Author(s):

Alexandra I. Merkulova ◽

Lyailya Kh. Dzhemlikhanova ◽

Dariko A. Niauri ◽

Alexander M. Gzgzyan ◽

Igor Yu. Kogan ◽

...

Keyword(s):

In Vitro Fertilization ◽

Aromatase Inhibitors ◽

Ovarian Stimulation ◽

Poor Response ◽

Ovarian Response ◽

Controlled Ovarian Stimulation ◽

Controlled Clinical Trial ◽

Poor Responders ◽

Vitro Fertilization

Hypothesis/aims of study. Poor ovarian response is still considered one of the most challenging tasks in reproductive medicine. Poor responders have decreased circulating androgens during spontaneous cycles. Androgens are known to play an important role in follicular growth and development. Hence, the use of various androgens and androgen inhibitors in poor responders undergoing ovarian stimulation for IVF has been proposed to improve efficacy of treatment. This study was aimed to examine the efficacy of aromatase inhibitors and androgens in infertility treatment in patients with poor response. Study design, materials and methods. This prospective cohort-controlled clinical trial included 204 patients under 42 years of age with infertility and poor response to ovarian stimulation. In vitro fertilization treatment with an antagonist FSH/hMG protocol with letrozole (5 mg/day) was administered in the first group of patients (n = 26) during the first 5 days of stimulation. Patients of the second group (n = 38) were applied testosterone (25 mg/day) transdermally, starting from the 5th day of the menstrual cycle preceding controlled ovarian stimulation for in vitro fertilization. The third group of patients (n = 18) was administered dehydroepiandrosterone (100 mg/day) for 3 months prior to controlled ovarian stimulation for in vitro fertilization. Results. Improved response to FSH stimulation with letrozole co-treatment was evidenced, with parameters of stimulation efficacy and embryo development being better in the testosterone group. No significant improvement in ovarian response markers, ovarian response to gonadotrophin stimulation and in vitro fertilization outcomes were found in poor responders receiving pre-treatment dehydroepiandrosterone. Conclusion. Further studies are necessary to improve approaches of testosterone and aromatase inhibitors use in poor responders undergoing in vitro fertilization.

Download Full-text