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Clinical and Experimental Obstetrics & Gynecology  2018, Vol. 45 Issue (5): 752-755    DOI: 10.12891/ceog4439.2018
Original Research Previous articles | Next articles
Should corifollitropin alfa be offered to patients with “genuine” poor response to controlled ovarian hyperstimulation?
V.S. Vanni1, 3, †, E. Zilberberg1, †, D. Manela1, R. Orvieto1, 2, *()
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
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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.
Key words:  Poor responders      COH      Bologna criteria      Corifollitropin-alfa     
Published:  10 October 2018     
*Corresponding Author(s):  R. ORVIETO     E-mail:  Raoul.orvieto@sheba.health.gov.il
About author:  † Contributed equally.

Cite this article: 

V.S. Vanni, E. Zilberberg, D. Manela, R. Orvieto. Should corifollitropin alfa be offered to patients with “genuine” poor response to controlled ovarian hyperstimulation?. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(5): 752-755.

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https://ceog.imrpress.com/EN/10.12891/ceog4439.2018     OR     https://ceog.imrpress.com/EN/Y2018/V45/I5/752

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