الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 91 |  |  |
| | | from | 91 | | |
Abstract
Poor ovarian responders involve 9–24% of patients undergoing in vitro fertilization (IVF), with the management of these patients posing an everyday practical challenge.
Owing to the follicular waves theory, two or three waves of folliculogenesis were detected during the interovulatory interval, two consecutive ovarian stimulation protocols could be initiated in the follicular phase and the subsequent luteal phase. This is an effective way to increase the number of oocytes and embryos obtained over a relative short period of time. Furthermore, there is increasing evidence that progestins can be a reliable method of preventing premature LH surge during ovarian stimulation.
The primary aim of this work was to assess the difference between the progestin primed double stimulation protocol and the conventional GnRH antagonist protocol in poor responders regarding the number of M2 oocytes retrieved, the fertilization rate, the implantation rate and the clinical pregnancy rate .While the secondary aims were assessing the difference in the ongoing pregnancy rate in both protocols, assessing the difference between the follicular phase and the luteal phase of the progestin primed double stimulation protocol regarding the number of M2 oocytes retrieved and the fertilization rate, assessing the difference between the follicular phase of the progestin primed double stimulation protocol and the first round of the conventional GnRH antagonist protocol regarding the number of M2 oocytes retrieved and the fertilization rate and cost analysis of both protocols.
This study was a randomized controlled study performed at infertility and assisted reproduction unit of El-Shatby Maternity Hospital and Madinah Fertility Center. The study was conducted on 90 infertile women indicated for ICSI with criteria of poor ovarian response defined by Bologna criteria. The patients were divided into two groups:
group 1:45 patients were given the progestin primed double stimulation protocol.
group 2: 45 patients were given the flexible GnRh antagonist follicular controlled ovarian stimulations will be done in 2 cycles.
In the ovarian stimulation phase, we have found that the total days of controlled ovarian hyperstimulation and the total dosage of gonadotropins were similar in both two groups. Additionally, the retrieved oocytes were statistically significant higher in the dual stimulation group. After the embryo transfer, no statistically significant difference was recorded in the implantation rate, clinical pregnancy rate or the ongoing pregnancy rate between both groups.