Luteal start of exogenous FSH in poor responder women.

Purpose: To compare the effectiveness of using recFSH commenced in the luteal phase with a long GnRH agonist protocol or in the early follicular phase with a short GnRH agonist protocol, in infertile women designated as poor responders undergoing treatment with assisted reproduction in a prospective, randomized, controlled study.

Materials And Methods: Forty-two couples undergoing an ICSI cycle of whom female partner diagnosed as poor responder were included in the study. Recombinant FSH was given daily from day 21 of the previous cycle upon initiation of GnRH agonist in the study group. Control group was given FSH on day 2 in a short protocol GnRH agonist regimen. The number of metaphase 2 oocytes was analysed as the main outcome measure; pregnancy rate and clinical pregnancy rate were secondary outcome measures.

Results: Patients in the study group had significantly higher number of metaphase 2 oocytes. Although not statistically significantly patients in the study group had higher pregnancy/clinical pregnancy rates, as well.

Conclusion: This preliminary study shows that luteal start of recFSH simultaneously with long protocol GnRH agonist in poor responder women produced better results comparing to short protocol GnRH agonist plus high dose FSH regimen.