GnRH-antagonist vs co-flare protocol for women of low ovarian reserve
Research type
Research Study
Full title
The use of GnRH antagonist versus co-flare protocol for women with low ovarian reserve undergoing first cycle of in vitro fertilization
IRAS ID
96379
Contact name
Tarek Gelbaya
Contact email
Sponsor organisation
University Hospitals of Leicester NHS Trust
Eudract number
2012-004824-39
ISRCTN Number
NA
Clinicaltrials.gov Identifier
NA
Research summary
Ovarian reserve is a term used to express the amount of oocytes (eggs) remaining in the ovary and correlates negatively with the woman’s age. However, ovarian reserve is determined by many other factors than the woman’s age such as genetic and environmental factors. A number of ovarian reserve tests are routinely performed before in vitro fertilisation (IVF) to help predict the woman’s response to ovarian stimulation drugs. The most commonly used ovarian reserve tests are serum follicle stimulating hormone (FSH), antral follicle count (AFC)using an internal (vaginal) ultrasound scan and serum antimullerian hormone (AMH). Various treatment protocols are used in women with low ovarian reserve and predicted poor ovarian response including the short gonadotrophin releasing hormone agonist (co-flare) and the gonadotrophin releasing hormone antagonist (GnRH-ant) protocols. the two protocols are very similar except for the drug that inhibit breakthrough ovulation before egg collection (GnRH-agonist or GnRH-antagonist). Previous studies that compared the two protocols in women who had one or two failed IVF treatment with low egg yield showed conflicting results. IVF is an expensive treatment and in current financial climate most couples are funded one IVF cycle only by the NHS. Therefore, it is important to find out which treatment protocol works better for women with predicted poor ovarian response who are receiving their first treatment cycle. Anecdotally, different units use different protocols for women with predicted poor ovarian response undergoing their first IVF cycle with no evidence from randomised controlled studies. We propose here to conduct a trial, in order to gain evidence-based information on the efficacy of the two protocols based on the number of eggs collected at IVF, numbers fertilized and the number of embryos developed as a result of fertilisation.
REC name
East Midlands - Leicester Central Research Ethics Committee
REC reference
13/EM/0328
Date of REC Opinion
18 Sep 2013
REC opinion
Favourable Opinion