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Assisted reproductive technology (ART), especially controlled ovarian stimulation (COS), significantly increased clinical pregnancy rates among infertile patients. However, about 9% to 24% of patients had poor ovarian response to gonadotropins (GNS) stimulation, which was called poor ovarian response (POR). In recent years, the diagnosis and treatment of patients with low fertility is the challenge for reproductive medicine. To better demonstrate the effectiveness of various interventions and distinguish the different subgroups of patients, 2016 POSEIDON (Patient-Oriented Strategies Encompassing Individualized Oocyte Number) standard changed low reaction into low prognosis of patient-oriented individual strategies to obtain eggs. For patients in group 3 and group 4 classified by POSEIDON, ovarian reserve function decline, follicular development desynchrony and low numbers of oocytes obtained lead to poor prognosis. In 2020, the prognosis based on Delphi method of assisted reproductive technology to treat low crowd diagnosis expert opinion in China recommended to give these patients conventional cosine solutions such as antagonist. In the first cycle, follicle stimulating hormone (FSH) starting dose of 225 ~ 300 iu is suggested to achieve plenty of ovarian stimulation for standards and maximize the benefits of superovulation. Because of the particularity of luteal support in the antagonist regimen, it is of great clinical significance to explore the trigger mode and combination mode of luteal support in the antagonist regimen for patients with poor prognosis.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Double trigger unit | Experimental | HCG: 6000IU (Ovidrel: 250ug) + GnRH-a (Troprilin) 0.2mg |
|
| HCG trigger unit | Sham Comparator | HCG: 6000IU (Ovidrel: 250ug) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ovidrel | Drug | recombinant human chorionic gonadotropin for injection |
|
| Measure | Description | Time Frame |
|---|---|---|
| Clinical pregnancy rate in each transplantation cycle | number of pregnant cases are confirmed by ultrasound/ total number of transplanted | 6 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Rate of cancelled cycle | number of cancelled cycles/ number of total cycles | 6 weeks |
| Number of mature eggs | number of matured oocytes |
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Inclusion Criteria:
Age less than or equal to 42 years old, AFC<5 and or AMH<1.2ng/ml â‘¡ Adopt antagonist program for controlled ovulation hyperstimulation (COH); patients with fresh cycle transplantation;
Accept conventional IVF or intracytoplasmic sperm injection (ICSI);
Exclusion Criteria:
Abnormal chromosome karyotype;
Severe endometriosis;
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Reproductive Medicine Center, The affiliated Drum Towel Hospital of Nanjing University Medical School | Recruiting | Nanjing | Jiangsu | 210008 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21505041 | Background | Ferraretti AP, La Marca A, Fauser BC, Tarlatzis B, Nargund G, Gianaroli L; ESHRE working group on Poor Ovarian Response Definition. ESHRE consensus on the definition of 'poor response' to ovarian stimulation for in vitro fertilization: the Bologna criteria. Hum Reprod. 2011 Jul;26(7):1616-24. doi: 10.1093/humrep/der092. Epub 2011 Apr 19. | |
| 26921622 |
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| ID | Term |
|---|---|
| C412828 | Ovidrel |
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| Troprilin | Drug | triptorelin acetate injection |
|
| 6 weeks |
| Number of high-quality embryos | number of D3 high quality embryos (≥7 scores) | 6 weeks |
| Implantation rate | number of gestational sacs/ number of transplanted embryos | 6 weeks |
| Early abortion rate | number of miscarriage cases/ number of pregnant cases confirmed by ultrasound | 6 weeks |
| Cumulative pregnancy rate per stimulation cycle | number of pregnant cases which are confirmed by ultrasound/ total number of stimulation cycle | 6 weeks |
| Poseidon Group (Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number); Alviggi C, Andersen CY, Buehler K, Conforti A, De Placido G, Esteves SC, Fischer R, Galliano D, Polyzos NP, Sunkara SK, Ubaldi FM, Humaidan P. A new more detailed stratification of low responders to ovarian stimulation: from a poor ovarian response to a low prognosis concept. Fertil Steril. 2016 Jun;105(6):1452-3. doi: 10.1016/j.fertnstert.2016.02.005. Epub 2016 Feb 26. No abstract available. |
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