Author/Authors :
Badawy, Ahmed Department of Obstetrics and Gynecology - Mansoura University, Mansoura, Egypt , Wageah, Alaa Department of Obstetrics and Gynecology - Mansoura University, Mansoura, Egypt , El Gharib, Mohamed Department of Obstetrics and Gynecology - Mansoura University, Mansoura, Egypt , Osman, Ezz Eldin Department of Obstetrics and Gynecology - Mansoura University, Mansoura, Egypt
Abstract :
The ovarian stimulation of poor responders still remains a challenging task for clinicians.
There are numerous strategies that have been suggested to improve the outcome
in poor responders but there is still no one pituitary down-regulation protocol
that best suits all women with such condition. Traditional GnRH agonist flare and
long luteal phase protocols do not appear to be advantageous. Reduction of GnRH
agonist doses, "stop" protocols, and microdose GnRH agonist flare regimes all appear
to improve outcomes, although the proportional benefit of one approach over
another has not been convincingly established. GnRH antagonists improve outcomes
in this patient population, although, in general, pregnancy rates appear to be lower in
comparison to microdose GnRH agonist flare regimes.
