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Comparison of GnRH agonist versus luteal estradiol GnRH antagonist protocol using transdermal testosterone in poor responders

OBJECTIVE: Transdermal testosterone has been used in different doses and in different stimulation protocols in poor responders. The aim of the present study is to compare the luteal estradiol/GnRH antagonists protocol versus long GnRH agonists in poor responder patients according to the Bologna crit...

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Autores principales: Fàbregues, Francesc, Solernou, Roser, Ferreri, Janisse, Guimerá, Marta, Peralta, Sara, Casals, Gemma, Peñarrubia, Joana, Creus, Montserrat, Manau, Dolors
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Brazilian Society of Assisted Reproduction 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6501741/
https://www.ncbi.nlm.nih.gov/pubmed/30614665
http://dx.doi.org/10.5935/1518-0557.20180090
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author Fàbregues, Francesc
Solernou, Roser
Ferreri, Janisse
Guimerá, Marta
Peralta, Sara
Casals, Gemma
Peñarrubia, Joana
Creus, Montserrat
Manau, Dolors
author_facet Fàbregues, Francesc
Solernou, Roser
Ferreri, Janisse
Guimerá, Marta
Peralta, Sara
Casals, Gemma
Peñarrubia, Joana
Creus, Montserrat
Manau, Dolors
author_sort Fàbregues, Francesc
collection PubMed
description OBJECTIVE: Transdermal testosterone has been used in different doses and in different stimulation protocols in poor responders. The aim of the present study is to compare the luteal estradiol/GnRH antagonists protocol versus long GnRH agonists in poor responder patients according to the Bologna criteria, in which transdermal testosterone has been used prior to the stimulation with gonadotropins. METHODS: In this retrospective analysis, a total of 141 poor responder patients according to the Bologna criteria were recruited. All patients were treated with transdermal testosterone preceding ovarian stimulation with gonadotropins during 5 days. In 53 patients we used the conventional antagonist protocol (Group 1). In 88 patients (GrH pituitary suppression was achieved by leuprolide acetate according to the conventional long protocol (Group 2). We analyzed the ovarian stimulation parameters and IVF outcomes. RESULTS: Comparing groups 1 and 2, there were no significant differences between cancellation rates and number of oocytes retrieved. However the total gonadotropin dose used and the mean length of stimulation were significantly lower in group 1 when compared to group 2. There were no significant differences in pregnancy outcomes; however, there was a slight increase in the implantation rate in group 1 vis-a-vis group 2, although statistical significance was not achieved. CONCLUSION: TT in poor responder patients can be effective both with the conventional agonist's long protocol and with the conventional antagonist's protocol. However, short regimes with previous estradiol antagonists in the luteal phase facilitate ovarian stimulation by shortening the days of treatment and the consumption of gonadotropins
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spelling pubmed-65017412019-05-20 Comparison of GnRH agonist versus luteal estradiol GnRH antagonist protocol using transdermal testosterone in poor responders Fàbregues, Francesc Solernou, Roser Ferreri, Janisse Guimerá, Marta Peralta, Sara Casals, Gemma Peñarrubia, Joana Creus, Montserrat Manau, Dolors JBRA Assist Reprod Original Article OBJECTIVE: Transdermal testosterone has been used in different doses and in different stimulation protocols in poor responders. The aim of the present study is to compare the luteal estradiol/GnRH antagonists protocol versus long GnRH agonists in poor responder patients according to the Bologna criteria, in which transdermal testosterone has been used prior to the stimulation with gonadotropins. METHODS: In this retrospective analysis, a total of 141 poor responder patients according to the Bologna criteria were recruited. All patients were treated with transdermal testosterone preceding ovarian stimulation with gonadotropins during 5 days. In 53 patients we used the conventional antagonist protocol (Group 1). In 88 patients (GrH pituitary suppression was achieved by leuprolide acetate according to the conventional long protocol (Group 2). We analyzed the ovarian stimulation parameters and IVF outcomes. RESULTS: Comparing groups 1 and 2, there were no significant differences between cancellation rates and number of oocytes retrieved. However the total gonadotropin dose used and the mean length of stimulation were significantly lower in group 1 when compared to group 2. There were no significant differences in pregnancy outcomes; however, there was a slight increase in the implantation rate in group 1 vis-a-vis group 2, although statistical significance was not achieved. CONCLUSION: TT in poor responder patients can be effective both with the conventional agonist's long protocol and with the conventional antagonist's protocol. However, short regimes with previous estradiol antagonists in the luteal phase facilitate ovarian stimulation by shortening the days of treatment and the consumption of gonadotropins Brazilian Society of Assisted Reproduction 2019 /pmc/articles/PMC6501741/ /pubmed/30614665 http://dx.doi.org/10.5935/1518-0557.20180090 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Fàbregues, Francesc
Solernou, Roser
Ferreri, Janisse
Guimerá, Marta
Peralta, Sara
Casals, Gemma
Peñarrubia, Joana
Creus, Montserrat
Manau, Dolors
Comparison of GnRH agonist versus luteal estradiol GnRH antagonist protocol using transdermal testosterone in poor responders
title Comparison of GnRH agonist versus luteal estradiol GnRH antagonist protocol using transdermal testosterone in poor responders
title_full Comparison of GnRH agonist versus luteal estradiol GnRH antagonist protocol using transdermal testosterone in poor responders
title_fullStr Comparison of GnRH agonist versus luteal estradiol GnRH antagonist protocol using transdermal testosterone in poor responders
title_full_unstemmed Comparison of GnRH agonist versus luteal estradiol GnRH antagonist protocol using transdermal testosterone in poor responders
title_short Comparison of GnRH agonist versus luteal estradiol GnRH antagonist protocol using transdermal testosterone in poor responders
title_sort comparison of gnrh agonist versus luteal estradiol gnrh antagonist protocol using transdermal testosterone in poor responders
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6501741/
https://www.ncbi.nlm.nih.gov/pubmed/30614665
http://dx.doi.org/10.5935/1518-0557.20180090
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