Strategies to optimize fertility treatment outcome in poor responders
Research type
Research Study
Full title
A study to evaluate the effectiveness of a structured treatment strategy for women with low ovarian reserve and expected poor fertility prognosis wishing to conceive using their own oocytes
IRAS ID
281109
Contact name
Rumana Rahman
Contact email
Sponsor organisation
Chelsea and Westminster Hospital NHS Foundation Trust
Clinicaltrials.gov Identifier
Pending, ClinicalTrials.gov
Duration of Study in the UK
1 years, 5 months, 1 days
Research summary
Studies have shown that 9-24% of fertility patients have a poor response to ovarian stimulation using exogenous gonadotropins during an IVF cycle. Among these patients there are many that have 'expected' poor response or poor fertility prognosis. This includes women with low ovarian reserve as confirmed by low anti-mullerian hormone (AMH) or antral follicle count (AFC), older women >40 years of age, women with history of poor response to maximum gonadotropin stimulation. The clinical management of these women has remained a challenge for reproductive specialists for many years since they have a low number of oocytes retrieved and high cycle cancellation rates which all eventually lead to low pregnancy rates. Currently, there is no single intervention or treatment strategy that is unanimously accepted as useful in improving the clinical outcome in poor responders. Therefore, in this study we aim to assess whether the clinical outcome and patient experience can be optimised by using a structured treatment strategy that involves hormonal pre-treatment to improve ovarian function/environment, counselling, nutritional assessment and supplement, prolonged pituitary suppression, maximum ovarian stimulation using FSH and LH, active luteal phase support and post treatment debrief and counselling. Patients identified as 'expected' poor responders at the Assisted Conception Unit of Chelsea and Westminster Hospital will be offered to participate in this study. The study will continue till the patient achieves a clinical pregnancy or has a failed cycle. During this process they will have trans-vaginal ultrasound scans twice a month to assess antral follicular wave pattern and endometrial thickness and have monthly bloods tests to check hormone profiles.
REC name
London - London Bridge Research Ethics Committee
REC reference
21/LO/0252
Date of REC Opinion
27 Apr 2021
REC opinion
Further Information Favourable Opinion