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Jan 2019, Vol 7, Issue 1
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Original Article
Fixed Versus Flexible Antagonist Protocol in Reduced Ovarian Reserve Patients: A Historical Cohort Study
Firouzeh Akbari Asbagh1, Zahra Dehbashi1, Mahmood Moosazadeh2, Amirhossien pourmand3, Mahbod Ebrahimi4, Naghmeh pourmand5, Parvin Akbari Asbagh6
1Department of Obstetrics & Gynecology, Tehran University of medical sciences, Tehran, Iran
2Assistant professor, Health Sciences Research center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
3School of medicine, Tehran University of medical sciences, Tehran, Iran
4Department of Obstetrics & Gynecology, Tehran University of medical sciences, Tehran, Iran
5General practitioner, Tehran University of medical sciences, Tehran, Iran
6Department of Pediatrics, Tehran University of medical sciences, Tehran, Iran


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Keywords : Fixed, Flexible, Ovarian
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Abstract

Objectives: The antagonist of gonadotropin releasing hormone has been proven to be effective and safe in preventing a surge in luteinizing hormone (LH) during in vitro fertilization (IVF) cycles. The differentiation of GnRh antagonist protocols was in timing the initiation of the GnRh antagonist. The aim of this research is comparison of fixed versus flexible antagonist regimens in reduced ovarian reserve patients to identify a better regimen in these patients.

Materials and Methods: This paper is a historical cohort. 129 patient files were investigated. A total of 48 files related to a fixed protocol and 66 files related to a flexible protocol were studied. The mean age, BMI, FSH and AMH, mean dose of gonadotropin and the mean length of IVF/ICSI cycles and mean count of oocytes and mean count of embryos with grading: good, fair and poor between the two groups were compared.

Results: The total and mean consumption of gonadotropin dose (recombinant FSH) in the flexible and fixed groups were significantly different (p=0.05). The mean antagonist (cetrotide) doses in the fixed and flexible groups were not significantly different but in the flexible group were lower. (p=0.50). The duration of gonadotropin consumption period in IVF/ICSI between the two groups were not significantly different.

Conclusion: The fixed protocol is recommended in reduced ovarian reserve patients because it is cost effective than the flexible protocol and simple to use.

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