[Factors affecting the results of in vitro fertilization--IV. Importance of the stimulation protocols combining GnRH analogs and HMG in women with unsuccessful stimulation with combinations of clomiphene citrate-HMG].

Poor responders, whose cycles were cancelled after CC-hMG stimulation because of inadequate response, were stimulated with GnRH analogues (Suprefact nasal spray) and hMG in short protocol. In this highly negative selected group the cancellation rate was significantly lower (16.2%) than in the "normal" IVF population stimulated with clomiphene citrate and hMG (24.8%). All other parameters (number of oocytes and embryos, pregnancy rate) did not differ in the two groups. Embryos were frozen in 23.4% of cycles after GnRH-hMG stimulation and in 26.1% of cycles after CC-hMG stimulation. In GnRH-a cycles more ampoules (17.7) were injected per patient than after CC-hMG protocols (11.1 ampoules). Severe ovarian hyperstimulation syndrome developed in 4.0% CC-hMG cycles and in 2.8% cycles where GnRH analogues were used.