IMR Press / CEOG / Volume 45 / Issue 5 / DOI: 10.12891/ceog4439.2018

Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 46 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Open Access Original Research
Should corifollitropin alfa be offered to patients with “genuine” poor response to controlled ovarian hyperstimulation?
V.S. Vanni1, 3, †E. Zilberberg1, †D. Manela1R. Orvieto1, 2, *
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1 Infertility and IVF unit, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
2 The Tarnesby-Tarnowski Chair for Family Planning and Fertility Regulation, at the Sackler Faculty of Medicine, Tel-Aviv University, Israel
3 Centro Scienze Natalità, Department of Obstetrics and Gynecology, IRCCS Ospedale San Raffaele, Milano, Italy
† Contributed equally.
Clin. Exp. Obstet. Gynecol. 2018, 45(5), 752–755; https://doi.org/10.12891/ceog4439.2018
Published: 10 October 2018
Abstract

Objective: To examine whether poor ovarian response (POR) patients during conventional IVF/ intracytoplasmic sperm injection (ICSI) cycle, may benefit from multiple-dose GnRH-antagonist protocol with 150 mg of corifollitropin alfa via a cohort historical study. at a Tertiary, University affiliated Medical Center. Materials and Methods: Eighteen POR patients, defined according to the Bologna criteria, who underwent a subsequent 150 mg corifollitropin alfa cycle, within three months of the previous failed conventional IVF/ICSI cycle were included. The elimination of bias in this selection, for the purposes of this study, was achieved by including only a subgroup of “genuine” poor responder patients, those who yielded up to three oocytes following COH with a minimal gonadotropin daily dose of 300 IU. One hundred fifty mg corifollitropin alfa, administered on day 2-3 of the menstrual cycle, followed highly purified human menotropin (HP-hMG) or rFSH + rLH from stimulation day 5-6, within a flexible multiple-dose GnRH-antagonist COH cycle. Pregnancy rate, number of oocytes retrieved, number of embryos transferred, and COH variables were assessed. Results: The corifollitropin alfa COH protocol provided a non-significant one more oocyte, with no pregnancies. Considering the equivalence of 150 mg corifollitropin alfa to 2,100 IU of FSH, offering corifollitropin has no cost-effective advantages. Discussion: The corifollitropin alfa COH is of no benefit for “genuine” POR and alternative strategies, such as increasing the daily FSH dose or proceeding to egg-donation, should be seriously considered for this population.
Keywords
Poor responders
COH
Bologna criteria
Corifollitropin-alfa
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