Microdose GnRH Agonist Flare-Up versus Ultrashort GnRH Agonist Combined with Fixed GnRH Antagonist in Poor Responders of Assisted Reproductive Techniques Cycles

Background: This study compares the microdose flare-up protocol to the ultrashort gonadotropinreleasinghormone (GnRH) agonist flare combined with the fixed multidose GnRH antagonistprotocol in poor responders undergoing ovarian stimulation.Materials and Methods: In this randomized clinical trial, 120 women who were candidates forassisted reproductive techniques (ART) and had histories of one or more failed in vitro fertilization(IVF) cycles with three or fewer retrieved oocytes were prospectively randomized into two groups.Group I (60 patients) received the microdose flare-up regimen and group II (60 patients) receivedthe ultrashort GnRH agonist combined with fixed GnRH antagonist.Results: There were no significant differences between the groups in the number of used gonadotropinampoules (p=0.591), duration of stimulation (p=0.610), number of retrieved oocytes (p=0.802),fertilization rate (p=0.456), and the number of transferred embryos (p=0.954). The clinical pregnancyrates were statistically similar in group I (10%) compared with group II (13.3%, p=0.389).Conclusion: According to our results, there is no significant difference between these protocolsfor improving the ART outcome in poor responders. Additional prospective, randomizedstudies with more patients is necessary to determine the best protocol (Registration Number:IRCT201105096420N1).