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Journal of Assisted Reproduction and Genetics

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01-12-2007 | Symposium of the Aging Ovary

Management of the poor responder: the role of GnRH agonists and antagonists

Author: Eric S. Surrey

Published in: Journal of Assisted Reproduction and Genetics | Issue 12/2007

Abstract

Purpose

Evaluate the relative benefit of various doses and regimens of GnRH agonists (GnRHa) and antagonists (GnRHant) in the management of the poor responder.

Methods

Review of English language publications with an emphasis on prospective randomized trials where available.

Results

The lack of a uniformly applied definition of the poor responder and dearth of prospective randomized trials make data analysis difficult. Traditional GnRHa flare and long luteal phase protocols do not appear to be beneficial. Reduction of GnRHa doses, “stop” protocols, and microdose GnRHa flare regimes all appear to enhance outcomes, although the relative benefit of one approach over another has not been conclusively demonstrated. GnRHant does improve outcomes in this patient population, although, in general, pregnancy rates appear to be lower in comparison to microdose GnRHa flare regimes.

Conclusions

There is no one controlled ovarian hyperstimulation (COH) protocol which is best suited for all poor responders. Low dose GnRHa regimes appear to be most advantageous. Prediction of compromised response prior to cycle initiation by a thorough assessment of ovarian reserve as well as a careful review of past response should allow for selection of an appropriate COH protocol for each individual patient.

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Title: Management of the poor responder: the role of GnRH agonists and antagonists
Author: Eric S. Surrey
Publication date: 01-12-2007
Publisher: Springer US
Published in: Journal of Assisted Reproduction and Genetics / Issue 12/2007
Print ISSN: 1058-0468
Electronic ISSN: 1573-7330
DOI: https://doi.org/10.1007/s10815-007-9180-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Management of the poor responder: the role of GnRH agonists and antagonists

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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