- 作者：Alon Kedem ; M.D. ; kedem2001@gmail.com" class="auth_mail ; Abraham Tsur ; M.D. ; Jigal Haas ; M.D. ; Gil M. Yerushalmi ; M.D. ; Ph.D. ; Ariel Hourvitz ; M.D. ; M.H.A. ; Ronit Machtinger ; M.D. ; Raoul Orvieto ; M.D. ; M.M.Sc.
- 关键词：Modified natural cycle ; IVF ; poor response
- 刊名：Fertility and Sterility
- 出版年：June 2014
- 年：2014
- 卷：101
- 期：6
- 页码：1624-1628
- 全文大小：172 K
Design
Cohort historic study.
Setting
Tertiary, university-affiliated medical center.
Patient(s)
One hundred eleven patients with POR, defined according to the Bologna criteria, who underwent a subsequent MNC-IVF within 3 months of the previous failed conventional IVF/ICSI cycle. The elimination of bias in this selection, for the purposes of this study, was achieved by including only a subgroup of “genuine” poor responder patients, those who yielded up to three oocytes after controlled ovarian hyperstimulation (COH) with a minimal gonadotropin daily dose of 300 IU.
Intervention(s)
Modified natural cycle IVF protocol with GnRH antagonist (GnRH-a) supplementation. Gonadotropin-releasing hormone antagonist treatment was started when a follicle of 13 mm was present. Two to three ampules of hMG were coadministered daily during the GnRH-a treatment.
Main Outcome Measure(s)
Live birth rate, pregnancy rate (PR), number of oocytes retrieved, and number of embryos transferred.
Result(s)
Live birth rate in “genuine” poor ovarian responders was <1%. Furthermore, in the subgroup of patients with POR who underwent a previous conventional IVF/ICSI cycle with a yield of only one oocyte, no pregnancies were achieved during the MNC-IVF cycle.
Conclusion(s)
Modified natural cycle-IVF is of no benefit for genuine poor ovarian responders and the option of egg donation should be seriously considered for this population.