Reduction of Progesterone Elevation at Trigger in POR After Long Acting COS Compared With Daily COS: a Prospective Randomized Trial
Reduction of Progesterone Elevation at Trigger in POR After Long Acting COS Compared With Daily COS: a Prospective Randomized Trial
The overarching objective of this research is to generate clinical evidence to argue the
 benefits of long acting stimulation protocol compared to the daily stimulation protocol in
 poor ovarian responder bologna' criteria patients after controlled ovarian stimulation.
 Reduction in the proportion of subjects with progesterone > 1.1 ng/ml on the day of
 triggering (day + 13) in the experimental group compared to the control group is expected.
Each patient will receive a first visit for infertility where will be collected subject
 history and baseline information, and meet all the inclusion / exclusion criteria. Eligible
 patients who agreed to participate will be randomized to either long acting standard COS with
 corifollitropin alpha or standard COS with daily FSH in a fixed GnRH antagonist protocol. All
 patients will be allowed to participate in the study only once and a written informed consent
 will be obtained from all, following consultation and before the initiation of the treatment.

 The endocrine profile of all the patients will be evaluated by analysis of serum
 progesterone, 17b-estradiol (E2), FSH and LH at different time points: basal condition,
 during stimulation, at the hCG day and at pick-up.

 Transvaginal follicular aspiration will be performed by ultrasound guidance 36 hours after
 hCG administration. The day of pick up oocytes will be fertilized with partner's semen; after
 3-5 days, on the base of its evolution, embryo will be transferred. 14 days after
 embryo-transfer a preg-nancy test will be performed. Follow up in case of obtained pregnancy
 will be done until 20 weeks of gestation and considered as ongoing pregnancy.

 The entire duration of the study is 24 months, the follow up of the last patients enrolled
 will be 6 months.
Inclusion Criteria:

 -  Indication to IVF treatment

 -  Normal BMI (18.5-24.9 kg/m2)

 -  AMH level < 1.1 ng/ml and/or AFC < 5 follicles and/or < 3 oo-cytes retrieved in
 previous cycle

 -  Regular menstrual cycles

 -  Signed informed consent

 Exclusion Criteria:

 -  Freeze all cycles for abnormal bleeding

 -  PCOS

 -  History of untreated autoimmune

 -  Endocrine or metabolic disorders

 -  Ovarian cystectomy or oophorectomy

 -  FSH ≥ 20 lU/L