Effect of pre-treatment prior to antagonist regimen on clinical outcome of expected poor ovarian reserves patients using poseidon criteria

PURPOSE: The study is aimed to analyse the effect of different pre-treatments on the IVF outcome of expected poor ovarian responders patients according to POSEIDON criteria. Method: Retrospective analysis of 364 cycles of expected POR patients who had IVF-ET from jan18 to jan20. Pre-treatment was given prior to gonadotrophins stimulation. The cycle were divided into OCP group A (N=167), estradiol valerate group B (N=56), no pre-treatment group C, (N= 141). Result: Demographic profile and controlled ovarian stimulation were nearly same for all POR patients where antagonist protocol was used with recombinant HCG for trigger and progesterone supplement in luteal phase. The Implantation rate was higher in Group A (26.2%) and in Group B (26.8%) as compared in Group C 14.5% (p 0.001).The clinical pregnancy was higher in Group A 36.1% and in Group B 42% as compared to Group C 21.2% (p 0.001). The abortion rate was lowest in Group A 11.4% as compared to 28.6% in Group B and 35.5% in Group C. Although biochemical pregnancy rate was lowest in Group B 19.6% as compared to Group A 31.1% and in Group C 34.0%. Conclusion: Pre-treatment prior to GnRh antagonist regimen in expected POR patient with OCP or estradiol valerate in luteal phase can improve clinical pregnancy outcome of POR patients. Estradiol valerate seems to be more effective than OCP. Although it may be associated with longer stimulation and higher gonadotropin consumption.