The success rate of any ovarian stimulation protocol in IVF treatment is determined by its pregnancy and live birth rates, including its affordability and patient’s compliance. The few literatures regarding ideal minimal stimulation regimen for POR patient is not clear as there are different pros and cons of different minimal protocols [2]. There is no evidence of superiority of one approach over another; however minimal stimulation protocol with low dose CC plus low dose Gn is associated with reduced discomfort and treatment burden [5].
Moreover there is lack of large study population or randomized control trials (RCT) and besides no protocol can make poor responders to become good responders, as poor responders have reduced number of follicles …show more content…
Consequently, few number of fresh embryos for transfer and high number of cryopreserved embryos was achieved, thereby increasing the cycle cancellation rate and reduces PR per initiated cycle in fresh cycle IVF. The ccHCG trigger protocol could therefore be regarded as an ideal protocol for stimulation of POR patients that needed embryo cryopreservation either as a result of bad health conditions that would affect the embryo-implantation, or based on patient’s request for other reasons. However, high numbers of punctured mature follicles, oocytes and available quality embryos was observed in ccL5d protocol compared to NC or non CC minimal stimulation protocols (Table 5 & 6). This gave ccL5d excess embryos for cryopreservation better than non CC protocols, in addition to better number of fresh ET than ccHCG trigger protocol; hence an opportunity to be used as frozen-thawed embryo in case of patient that needs second child or cases of miscarriage without undergoing another ovarian stimulation. Interestingly, ccL5d protocol showed similar PR and LBR with NC or non CC protocol based on statistical analysis of no significant difference, but has better clinical outcomes when compared with ccHCG trigger protocol for POR patients who underwent IVF treatment and had fresh embryos transferred. The superiority of NC and non CC protocols compared to ccHCG trigger protocol in clinical outcomes was obvious (Table 8). The shortened duration CC protocol in this study (ccL5d) stimulated the ovary by sustaining FSH secretion from the pituitary gland and also reduces the inhibitory duration effect of clomiphene on
Moreover there is lack of large study population or randomized control trials (RCT) and besides no protocol can make poor responders to become good responders, as poor responders have reduced number of follicles …show more content…
Consequently, few number of fresh embryos for transfer and high number of cryopreserved embryos was achieved, thereby increasing the cycle cancellation rate and reduces PR per initiated cycle in fresh cycle IVF. The ccHCG trigger protocol could therefore be regarded as an ideal protocol for stimulation of POR patients that needed embryo cryopreservation either as a result of bad health conditions that would affect the embryo-implantation, or based on patient’s request for other reasons. However, high numbers of punctured mature follicles, oocytes and available quality embryos was observed in ccL5d protocol compared to NC or non CC minimal stimulation protocols (Table 5 & 6). This gave ccL5d excess embryos for cryopreservation better than non CC protocols, in addition to better number of fresh ET than ccHCG trigger protocol; hence an opportunity to be used as frozen-thawed embryo in case of patient that needs second child or cases of miscarriage without undergoing another ovarian stimulation. Interestingly, ccL5d protocol showed similar PR and LBR with NC or non CC protocol based on statistical analysis of no significant difference, but has better clinical outcomes when compared with ccHCG trigger protocol for POR patients who underwent IVF treatment and had fresh embryos transferred. The superiority of NC and non CC protocols compared to ccHCG trigger protocol in clinical outcomes was obvious (Table 8). The shortened duration CC protocol in this study (ccL5d) stimulated the ovary by sustaining FSH secretion from the pituitary gland and also reduces the inhibitory duration effect of clomiphene on