Efficacy of the depot gonadotropin-releasing hormone agonist protocol on in vitro fertilization outcomes in young poor ovarian responders from POSEIDON group 3

Objective To investigate whether the depot gonadotropin-releasing hormone (GnRH) agonist protocol could improve in vitro fertilization (IVF) outcomes for young poor responders from POSEIDON group 3. Methods This retrospective cohort study was carried out from June 2017 to June 2020. A total of 451 patients were assigned to three groups depending on the ovarian stimulation protocols. The outcome parameters of IVF were compared in each group. Results Patients who received the depot GnRH agonist had significantly higher cumulative clinical pregnancy rates (50.88%, 32.02%, and 31.88%, respectively; P = 0.009 and P = 0.007) and cumulative live birth rate (48.25%, 26.97%, and 28.99%, respectively; P = 0.004 and P = 0.009) compared with mild ovarian stimulation protocol and GnRH antagonist protocol. They also had higher live birth rate per fresh embryo transfer cycle (47.78%, 32.35%, and 36.62%, respectively), but these differences were not statistically significant. Moreover, duration of stimulation, total dose of gonadotropins and endometrial thickness were significantly higher among women who received the depot GnRH agonist (P < 0.001). However, they had lower embryo transfer cancellation rate, and abnormal endometrium rate (P < 0.001). Conclusion The depot GnRH agonist protocol may improve cumulative clinical pregnancy rate and cumulative live birth rate for young women with poor ovarian response from POSEIDON group 3.

Automated summary

The depot GnRH agonist protocol showed significantly higher cumulative clinical pregnancy rates and cumulative live birth rates compared to mild ovarian stimulation protocol and GnRH antagonist protocol. Women who received the depot GnRH agonist had higher stimulation duration, total dose of gonadotropins, and endometrial thickness, as well as lower embryo transfer cancellation rate and abnormal endometrium rate.