P-82: Antagonist/Letrozole Protocol in Poor Ovarian Responder Patients Undergoing Intracytoplasmic Sperm Injection- Embryo transfer Cycles

Background The optimal stimulation protocol for poor responder patients is a therapeutic challenge. GnRH antagonist protocol has been proposed as a potentially proper option for poor responders. Nevertheless, there is no significant difference in terms of clinical pregnancy and cancellation rates be tween the GnRH antagonist and agonist cycles. Therefore, this subset of patients might be the best to benefit from new treatment strategies that make better outcomes. The use of aromatase inhibitors such as letrozole were advocated by some studies. The aim of this study was the evaluation of aromatase inhibition by letrozole on outcome of antagonist protocol in poor responder patients undergoing ICSI cycles. MaterialsAndMethods It is a Double-blinded randomized control trial in the University-affiliated IVF unit. Based on Bologna criteria, 83 infertile women were labeled as poor ovarian responder. They were enrolled in two groups; letrozole/GnRH-antagonist (LA) group (n=35) involved at letrozole 2.5 mg over 5 days and recombinant human follicle stimulating hormone (rhFSH) with starting daily dose of 225IU and placebo/GnRH-antagonist (PA) group (N=35) received placebo over 5 days and (rhFSH) at the same dose and starting day as group (PA). In both groups, the central blockage was achieved by the use of the GnRH antagonist (cetrotide) in a flexible fashion. The ICSI outcomes were compared between the groups. Results There were no significant differences in demographic characteristics between the groups. There were no significant differences between the groups regarding the number of oocytes retrieved (2.8 ± vs. 2.6 ± P=0.81) , number of embryos transferred (1.02 ± 0.75 vs. 1.23 ± 0.84, P=0.82) , implantation rate (11.9% vs. 9.5%, P=0.72) , total cycle cancelation rate (20% vs. 22.9%, P=0.08) , clinical pregnancy rate (17.85% vs. 14.81% P=0.76 ) . Conclusion There is no benefit for adding of letrozole in GnRH-antagonist protocol for poor responder patients undergoing ICSI.