Infertility
Conditions
Brief summary
Poor ovarian response indicates inadequate ovarian response to ovarian stimulation. In the current study the investigators will attempt to compare antagonist and short protocols regarding oocyte as well as embryo quantity and quality. Frozen embryo transfer will be performed in order to abolish iatrogenic effect of stimulation drugs on implantation. Still implantation and pregnancy rates are considered secondary outcomes.
Interventions
PROCEDUREIVF/ICSI
controlled ovarian hyperstimulation with various protocols, follow up till stimulated follicles measure from 18-20 mm, then ovum pickup followed by embryo transfer is done.
Sponsors
Nile Ivf Center, Cairo, Egypt
Kamal Shaeer center of infertility
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
25 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* Patient selection is based on the ESHRE consensus group 2011 definition of poor ovarian response (POR) (Bologna criteria): * At least two of the following three features must be present: 1. Advanced maternal age (≥40 years) or any other risk factor for POR; 2. A previous POR (≤3 oocytes with a conventional stimulation protocol); 3. An abnormal ovarian reserve test (i.e. Antral follicle count (AFC) \<5-7 follicles or Antimullerian hormone (AMH) \<0.5-1.1 ng/ml). Two episodes of POR after maximal stimulation are sufficient to define a patient as poor responder in the absence of advanced maternal age or abnormal Ovarian reserve test (ORT). By definition, the term POR refers to the ovarian response and, therefore, one stimulated cycle is considered essential for the diagnosis of POR. However, patients over 40 years of age with an abnormal ORT may be classified as poor responders since both advanced age and an abnormal ORT may indicate reduced ovarian reserve and act as a surrogate of ovarian stimulation cycle. In this case, the patients should be more properly defined as expected PORs.
Exclusion criteria
* Women with endometriosis, endocrinal problems, uterine abnormalities as well as male azospermia.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Metaphase II (MII) oocytes | 9-14 days from stimulation | Number of MII oocytes collected from each patient on the day of ovum pickup (OPU) |
| Number of good embryos | 3-5 days after ovum pickup | the number of good quality embryos obtained from each patient |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Implantation rate | 5 weeks after embryo transfer | the ratio between the number of embryos transferred and the number of sacs |
| Early miscarriage rate | 3 months | Pregnancy loss in the first 12 weeks gestation |
| chemical pregnancy rate | 14 days after embryo transfer | positive serum Beta HCG 14 days after embryo transfer |
| Live birth rate | 9 months | Pregnancy ending with a live birth |
| Ongoing pregnancy rate | 3 months | Pregnancy ongoing beyond 12 weeks gestation |
| clinical pregnancy rate | 5 weeks after embryo transfer | the detection of intrauterine gestational sac with positive pulsations |
Countries
Egypt
Outcome results
None listed