Effects of GnRH Antagonist/Letrozole Stimulation Protocol on Outcomes of Intracytoplasmic Sperm Injection Cycles in Poor Ovarian Responders

Abstract

In this retrospective study it was aimed to compare the effects of letrozole added GnRH antagonist controlled ovarian hyperstimulation (COH) protocol to the intracytoplasmic sperm injection (ICSI) cycle outcomes comparing with previous antagonist COH cycles, in patients with diminished ovarian reserve (DOR) and who did not achieved live birth, Twenty-six patients who underwent COH for ICSI between June 2013 and December 2015 were included in the study. Using the electronic database, the COH protocol characterictics of 26 patients who underwent ICSI with indications of DOR were determined. When letrozole was added in the early follicular phase to the conventional antagonist stimulation protocol, in 26 patients previously performed embryo transfer resulting without live birth , total gonadotrophine dose used was significantly lower in the letrozole cycles (p = 0.035), besides number of the retrieved oocyte, mature oocyte, fertilization rate, number of embryos obtained, transferred embriyo numbers, frozen embriyo numbers and clinical pregnancy rates did not show any significant difference comparing with previous antagonist cycles.

Keywords

• Diminished ovarian reserve,Intracytoplasmic sperm injection,GnRH antagonist,Letrozol

Düşük Over Rezervli Hastalarda GnRH Antagonist/Letrozol Stimülasyon Protokolünün Kullanılmasının İntrasitoplazmik Sperm Enjeksiyonu Siklus Sonuçlarına Etkisi

Abstract

Bu retrospektif çalışmada daha önce düşük ovaryan rezerv (DOR) endikasyonu ile intrasitoplazmik sperm enjeksiyonu (ICSI) siklusu yapıl-ması amacı ile antagonist protokoller ile kontrollü ovaryan hiperstimülasyon (KOH) uygulanmış ve canlı doğum elde edilemeyen hastalarda, takip eden stimülasyon siklusunda antagonist protokole aromataz inhibitörü olan letrozol eklenmesinin siklus sonuçlarına etkisi önceki tedavi siklusları ile karşılaştırılarak değerlendirilmesi hedeflenmiştir. Çalışmaya Haziran 2013- Aralık 2015 yılları arasında ICSI için KOH uygula-nan 26 hasta dahil edildi. Elektronik veri tabanı kullanılarak, DOR endikasyonu ile ICSI uygulanmış olan 26 hastanın KOH protokolü karak-tarestikleri belirlendi. Önceki KOH siklusları sonrası embriyo transferi yapılarak canlı doğum elde edilemeyen 26 hastaya takip eden tedavi sikluslarında erken folliküler fazda konvansiyonel antagonist stimülasyon protokolüne letrozol eklendiğinde önceki KOH siklusları ile karşılaştırıldığında; kullanılan total gonadotropin dozu anlamlı olarak düşerken (p= 0.035), elde edilen oosit, matür oosit, döllenme oranı, elde edilen embriyo sayısı, transfer edilen embriyo sayıları, dondurulan embriyo sayıları ve klinik gebelik oranların anlamlı farklılık göstermediği tespit edildi.

Keywords

• Letrozol,Düşük over rezervi,Intrasitoplazmik sperm enjeksiyonu,GnRH antagonist

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