Adjuvant treatment strategies in ovarian stimulation for poor responders undergoing IVF:

In a systematic review and network meta-analysis (2020)

Despite great advances in assisted reproductive technology, poor ovarian response (POR) is still considered as one of the most challenging tasks in reproductive medicine.

OUTCOMES

Compared with controls,

·        DHEA and CoQ10 treatments resulted in a significantly higher chance of clinical pregnancy.

·        HCG, oestradiol and GH treatments had the highest number of oocytes retrieved.

·        Testosterone and GH treatment led to the highest number of embryos transferred.

·        GH resulted in the highest oestradiol level on the HCG day.

·        Clomiphene citrate, letrozole and GH groups used the lowest dosages of gonadotrophins for ovarian stimulation.

·        CoQ10 led to the lowest global cancelation.

WIDER IMPLICATIONS

For patients with POR, controlled ovarian stimulation protocols using adjuvant treatment with DHEA, CoQ10 and GH showed better clinical outcomes in terms of achieving pregnancy, and a lower dosage of gonadotrophin required for ovulation induction.