Özet:

Purpose: Compare the effectiveness of different protocols, such as GnRH antagonist, and long GnRH agonist, applied in patients with low over reserve diagnosis to IVF program, in IVF success. Tools and methods: Patients who apply to the IVF Clinic of the University of Health Sciences of Ankara Etlik Zübeyde Women's Education and Research Hospital between January 2010 and May 2019 and who received a low over reserve diagnosis were included in the study. 713 women were divided into 3 groups according to the controlled ovarian stimulation protocols used: the group A(n=327) GnRH antagonist protocol, the group B(n=184), the long GnRH agonist protocol and the group C (n=202) microdoz flare-up protocol. Among the groups, ovarian stimulation characteristics and clinical pregnancy results were compared. Results: 713 facts were included in study. Long GnRH agonist protocol group found a significantly longer stimulation time and a greater number of maturated oocytes (p=0.001) compared to Group A and Group C. The total dose of gonadotropin and cycle cancellation rates were significantly increased in group C(p=0.001).There was no significant difference in the number of oocytes collected between the groups. There was no significant difference between the groups in terms of clinical pregnancy rates (p=0.337). The result: Due to the reduction in the duration and cost of treatment in women with low over reserves, GnRH antagonist protocol can be considered the first treatment option.

Anahtar Kelimeler:

Özet:

Objective: To compare the effect of gonadotropin-releasing hormone (GnRH) antagonist protocol, microdose flare-up protocol and long GnRH agonist protocol in patients receiving in vitro fertilization/ intracytıplasmic sperm injection (IVF/ICSI)treatment due to poor response . Materials and methods: In a retrospective study, the records of patients who were poor responders attending University of Health Sciences Ankara Etlik Zübeyde Hanım Womens Health Application and Research Center, IVF Clinic between January , 2010 and May, 2019 were retrieved. Overall 713 patients were divided into 3 groups: Group A(n=327) gonadotropin-releasing hormone (GnRH) antagonist protocol, Group B(n=184) long GNRH analog protocol, Group C( n=202) microdose flare-up protocol. The ovarian stimulation characteristics as well as the clinical pregnancy rates were compared between groups. Results: Seven hundred and thirteen patients included in the study.Treatment duration and number of mature oocytes were significantly higher in women undergoing the long GnRH agonist regimen compared with Group A and Group C(p=0.001 for both). The cycle cancellation rate and total gonadotropin dose were significantly higher in group C (p=0.001). A significant difference was not observed with respect to the number of retrieved oocytes . No statistically significant differences were detected in clinical pregnancy rates between the groups (p=0.337). Conclusion: GnRH antagonist regimen may be preferable to other protocols as it could decrease the cost and treatment duration in poor responders