Stop GnRH-agonist combined with multiple-dose GnRH-antagonist protocol for patients with IVF failures due to poor embryo quality-A proof of concept

Objective: To evaluate the role of the Stop GnRH-agonist combined with multiple-dose GnRH-antagonist protocol in improving IVF outcome in patients with repeated IVF failures and poor embryos quality. Materials And methods:A proof of concept study consisting of 23 patients with IVF failures and poor embryos quality during conventional GnRH-antagonist protocol, who underwent a subsequent Stop GnRH-agonist combined with multiple-dose GnRH-antagonist ovarian stimulation (OS) protocol.Results: During the Stop GnRH-agonist combined with multiple-dose GnRH-antagonist OS protocol, patients revealed significantly longer stimulation (10.7+2.3 vs 9.3+1.9days, p<0.01, respectively), with no in-between group differences in the number of oocytes retrieved or the number of MII oocytes.Moreover, the number of TQE (2.8+2.2 vs 0.9+0.8,p<0.001, respectively) and the proportion of the number of TQE/number of MII oocytes retrieved (38+23 vs 14+13%, p<0.001) were significantly higher, as compared to their previous control cycles.Seven clinical pregnancies (30.4%) were recorded in the study group and none in the control group. Conclusion:Patients with repeated IVF failures and poor embryos quality may benefit from the combined Stop GnRH-ag/ GnRH-ant OS protocol.Further large studies are required, aiming to validate our findings and to establish the appropriate patients' characteristics.