Does unplanned agonist-stop protocol rescue the intracytoplasmic sperm injection cycle?: a randomized controlled study

Abstract

Objective

The aim of this study was to evaluate the effect of stopping the agonist with the first follow up visit when the initial response was poor in cases undergoing intracytoplasmic sperm injection, comparing this to the conventional continuation of the agonist.

Methodology

A prospective single blinded study was conducted on 50 infertile cases who were planned to have intracytoplasmic sperm injection by long protocol in infertility unit of El-Shatby Maternity University Hospital in the period between May 2011 and January 2013 and these patients had poor response on day 6 of stimulation (serum estradiol (E2) less than 100 pg/ml and 5 or less follicles developed). They were randomly allocated by closed envelope method into two groups, (I) 30 patients to whom we stopped the agonist and continued stimulation and (II) 20 patients to whom we continued the agonist together with stimulation.

Results

Group II had statistically higher days of stimulation than group I (p = 0.009). The number of metaphase II oocytes did not show statistical significant difference between the two groups (p = 0.418). The mean of number embryos replaced were statistically higher in group II than group I (p = 0.025). Pregnancy rate showed no statistical significant differences between the two studied groups (p = 0.466).

Conclusions

There was no difference between stopping the agonist or continuing it when the initial response was poor on first follow up visit in cases undergoing intracytoplasmic sperm injection.

Recommendations

Alternative measures should be looked for, to improve results of intracytoplasmic sperm injection when initial response is poor.