A comparison of three downregulation approaches for poor responders undergoing in vitro fertilization

Laura Detti, Daniel B. Williams, Jared C. Robins, Rose A. Maxwell, Michael A. Thomas*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

46 Scopus citations


Objective: To assess the efficacy of three different GnRH agonist (GnRH-a) stimulation regimens to improve ovarian response in poor responders undergoing IVF. Design: Retrospective cohort study. Setting: Center for Reproductive Health at the University of Cincinnati Medical Center. Patient(s): Women diagnosed as poor responders who presented consecutively from January 1999 to January 2004. Intervention(s): Patients underwent three different stimulation regimens during IVF cycles: [1] stop protocol: GnRH-a 500 μg/d administered from the midluteal phase to the start of menses, then gonadotropins from day 2 of cycle, [2] microdose flare: GnRH-a 20 μg administered twice daily with gonadotropins from day 2 to the day of hCG administration, or [3] regular dose flare: gonadotropins beginning with GnRH-a on day 2 at 1 mg/d for 3 days, followed by 250 μg/d until the day of hCG administration. Main Outcome Measure(s): Ovarian response, implantation rates, clinical pregnancy and delivery rates. Result(s): Sixty-one IVF cycles were included in the study. None of the comparisons reached statistical significance; however, the microdose group demonstrated a trend toward a higher completed pregnancy rate. Conclusion(s): The microdose flare protocol for poor responders demonstrated a trend toward higher delivery rates. A larger prospective study would need to be performed to determine whether this trend leads to a significant finding in this patient population.

Original languageEnglish (US)
Pages (from-to)1401-1405
Number of pages5
JournalFertility and Sterility
Issue number5
StatePublished - Nov 2005


  • Assisted reproduction technologies
  • Controlled ovarian hyperstimulation
  • Decreased ovarian reserve
  • Flare stimulation protocols
  • GnRH agonist
  • ICSI
  • IVF
  • Infertility
  • Ovarian downregulation
  • Poor responder

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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