Day 6 estradiol level predicts cycle cancellation among poor responder patients undergoing in vitro fertilization - Embryo transfer cycles using a gonadotropin-releasing hormone agonist flare regimen

Kovács, Péter Tamás and Witt, Barry R. (2002) Day 6 estradiol level predicts cycle cancellation among poor responder patients undergoing in vitro fertilization - Embryo transfer cycles using a gonadotropin-releasing hormone agonist flare regimen. JOURNAL OF ASSISTED REPRODUCTION AND GENETICS, 19 (7). pp. 349-353. ISSN 1058-0468

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Abstract

Purpose: To compare two GnRHa flare protocols among poor responders undergoing IVF-ET and to evaluate if a Day 6 estradiol level can predict outcome. Methods: Retrospective analyses of GnRHa flare IVF cycles among poor responders. Group A ("miniflare," N = 36) 40 mug GnRHa s.c. b.i.d. from Day 3; Group B ("standard flare," N = 24) 1 mg GnRHa on Days 2-3; 0.5 mg GnRHa from Day 4. ROC analysis was performed to find a Day 6 estradiol value that is predictive of cycle outcome. Results: With the standard flare, patients required less gonadotropins and tended to have fewer cancellations and higher pregnancy rates. A Day 6 estradiol level less than or equal to75 pg/mL was predictive of cycle cancellation, but not of pregnancy outcome. Conclusions: Standard GnRHa flare offers some advantages over the miniflare. Day 6 estradiol less than or equal to75 pg/mL is predictive of cycle cancellation. When the estradiol level is low on Day 6 (no flare), early cancellation should be considered.

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