A Feasible Option before Cycle Cancellation for Poor Responders; STOP-START Protocol


ATABEKOĞLU C. S., ŞÜKÜR Y. E., ÖZMEN B., SÖNMEZER M., BERKER B., Aytac R.

INTERNATIONAL JOURNAL OF FERTILITY & STERILITY, cilt.15, sa.4, ss.300-302, 2021 (ESCI) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 15 Sayı: 4
  • Basım Tarihi: 2021
  • Doi Numarası: 10.22074/ijfs.2021.134626
  • Dergi Adı: INTERNATIONAL JOURNAL OF FERTILITY & STERILITY
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Academic Search Premier, CINAHL, EMBASE, Directory of Open Access Journals
  • Sayfa Sayıları: ss.300-302
  • Anahtar Kelimeler: Assisted Reproductive Techniques, Folliculogenesis, Ovarian Stimulation, Unresponsive, OVARIAN STIMULATION
  • Ankara Üniversitesi Adresli: Evet

Özet

Despite the advances in controlled ovarian stimulation (COS), management of a subgroup of poor ovarian responder patients may still be challenging. We describe a feasible and simplified protocol, namely the STOP-START protocol, for poor responders defined as Patient-Oriented Strategies Encompassing Individualize D Oocyte Number (POSEI-DON) groups 3 and 4, who are unresponsive to COS with maximum dose gonadotrophins Data of 11 women unresponsive to COS were reviewed. Mean age of the patients was 36.5 +/- 6.0 years. Unresponsiveness was defined as no follicular growth >9 mm and/or estradiol level less than 40 pg/ml after a week of recombinant follicle stimulating hormone (rFSH, 225-3001U) administration. In that case, COS was stopped and each woman underwent weekly ultrasound assessment to catch a secondary follicular growth. All women showed at least one follicular growth within five to 20 days. Six women (54.5%) had spontaneous follicular growth and the other five required ovarian stimulation. At least one oocyte was retrieved from each one of seven patients (63.6%). The mean number of oocytes retrieved was 1.6 +/- 1.4 and five women (45.5%) had at least one grade A embryo. Among all, two women became pregnant successfully and both gave live births (18.2%). In conclusion, STOP-START protocol may potentially be an effective, feasible. and time-saving management option for POSEIDON group 3/4 poor responders who are unresponsive to standard COS treatment with maximum dose gonadotrophins.