Analysis of different ovarian stimulation protocols for IVF/ICSI therapy to infertile women with advanced age and poor ovarian response

Objective To compare the effect of different ovarian stimulation protocols in poor ovarian response patients aged 40 years or older for in vitro fertilization (IVF/ICSI). Methods A total of 168 cycles of 115 patients with poor ovarian response and aged 40 years or older undergoing IVF/ICSI therapy with different methods including long gonadotropin releasing hormone agonist (GnRH-a) protocol, short GnRH-a protocol and micro stimulation from January 2013 to August 2015 in Chinese PLA General Hospital were analyzed. They were divided into three groups according to different ovarian stimulation protocols, and the clinical data and outcomes were compared between three groups. Results There was no statistical difference in general characteristics, fertilization rate, the rate of high quality embryo and clinical pregnancy rate (P＞ 0.05). But the duration and dosage of gonadotropin (Gn) administration in micro-stimulation protocol group differed significantly comparing with the other two groups (735.75±725.25) IU vs (2 749.50±724.50) IU, (2 248.50±800.25) IU; (7.03±2.74) d vs (9.76±1.40) d, (9.51±2.40) d, P＜ 0.05. And long GnRH-a protocol group got more oocytes retrieved than the other two groups (5.90±4.44) vs (4.07±2.59), (3.86±3.03), P＜ 0.05. Conclusion Compared with long and short GnRH-a protocols, micro-stimulation protocol reduces Gn dosage, which seems to be the most economic and effective choice for aged women with poor ovarian response.