Dergiler / Erciyes Tıp Dergisi / 2013 / Cilt: 35 - Sayı: 2
Comparison of GnRH-agonist microdose flare-up protocol and flexible multiple dose antagonistic protocol in poor responder patients undergoing intracytoplasmic sperm injection cycle
- Dergi
- Erciyes Tıp Dergisi
- Sayfa
- 52–55
- DOI
- —
Özet
Amaç: İntrasitoplazmik sperm injeksiyonu (ICSI) yapılan zayıf over yanıtlı olguların kontrollü ovaryan stimulasyon sikluslarında mikrodoz flare-up ile multidoz GnRH-antagonist protokollerinin karşılaştırılması. Gereç ve Yöntemler: Erciyes Üniversitesi Tıp Fakültesi Tüp Bebek Ünitesi’nde 2005-2012 yılları arasında ICSI yapılan 1927 olgudan zayıf over yanıtı olan 216 hasta çalışmaya dahil edildi. Hastalar mikrodoz GnRH-agonist flare-up (Grup 1, n:69), GnRH- antagonist (Grup 2, n:147) olarak gruplandı. Gruplar kullanılan siklus parametreleri ve klinik gebelik oranları açısından karşılaştırıldı. Bulgular: Demografik ve klinik verilerin karşılaştırılmasında, gruplar arasında infertilite süresi (12,10±5,87 yıl vs 9,32±5,57 yıl) dışında anlamlı fark izlenmedi. İki grup arasında, gonadotropin dozu, E2 düzeyi, endometrial kalınlık/patern parametreleri açısından istatistiksel olarak anlamlı fark izlenmezken, total ve matür oosit sayısı antagonist grubunda anlamlı derecede yüksek bulundu (3,97±3,66 vs 5,41±4,65, ve 2,88±3,15 vs 4,27±3,78, p
Abstract
Objective: To compare the efficacy of the microdose flare-up and multiple-dose antagonist protocols for poor responder patients in intracytoplasmic sperm injection (ICSI). Materials and Methods: Of 1927 patients who had undergone ICSI cycles in the Erciyes University Department of Assisted Reproduction between 2005- 2012, 216 poor responder patients were included in the study. There were 69 patients in the microdose flare-up group, and 147 patients- in the antagonist group. The groups were compared in terms of cycle parameters, and clinical pregnancy rate (CPR). Results: The groups were identical with regard to demographic parameters, with the exception of duration of infertility, which was significantly longer in the microdose group (12.10±5.87 years 9.32±5.57 years). No significant difference was found between groups in terms of gonadotropin- doses, E2 levels, endometrial thickness and pattern. Total and mature oocyte numbers were higher in the antagonist group (3.97±3.66 vs 5.41±4.65, and, 2.88±3.15 vs 4.27±3.78, respectively). CPRs were comparable between groups (%10.1 vs %19). Conclusion: Microdose GnRH-a flare-up and multiple dose GnRH antagonist protocols have similar CPR in poor responder patients undergoing ICSI cycles. In view of its lower cost and yielding higher total and mature oocytes, GnRH antagonist could be preferred to the microdose flare protocol.