gnrha stop protocol versus long protocol in poor responder ivf patients

Background: recently different studies suggested that discontinuation ofgonadotrophin releasing hormone analogue (gnrha) at beginning of ovarianstimulation (improvement of ovarian response to gonadotrophins) may have somebenefit to poor responder patients in invitro fertilization (ivf) cycles.objective:the efficacy of gnrha stop protocol in poor responder patients in ivfcycles was assessed.materials and methods: this study was a prospective, randomized controlled trial that40 poor responder patients (less than three mature follicles in a previous cycle) withnormal basal follicle stimulating hormone (fsh) were randomly allocated into twoprotocols: 1) non-stop protocol: long gnrha suppression, and start gonadotrophinsfrom day 3 of mense. 2) stop-protocol: gnrha is stopped with the onset of menses,and gonadotrophin doses remained similar to group 1.results: a significantly higher number of follicles, oocytes, embryos and fertilizationrate also shorter stimulation days and lower human menopausal gonadotropins (hmg)ampoules were recorded in the stop protocol compared to the control group. bothprotocols resulted in a similar cancellation rate, pregnancy rate, estradiol level and lhlevel.conclusion: early follicular cessation of gnrha permitted the retrieval of asignificantly higher number of follicles, oocytes and embryos, and can reduce thenumber of hmg and stimulation days.