High-dose human menopausal gonadotropin stimulation in poor responders does not improve in vitro fertilization outcome

Objective: To study the outcome in poor responders to three ampules (225 IU) of hMG per day in subsequent IVF treatment cycles in which six ampules (450 IU) of hMG per day were administered. Design: Retrospective chart review. Setting: Academic tertiary center. Patients: Between January 1988 and May 1995, 126 poor response patients had a first treatment cycle on three ampules and a second cycle on six ampules of hMG per day. Main Outcome Measures: Numbers of follicles, oocytes, and embryos, and pregnancy rates. Results: On six ampules, patients had significantly more follicles and oocytes. The number of embryos did not differ significantly. The pregnancy rate on six ampules was low (3.2% pregnancies per cycle started). Conclusion: Poor responders do not benefit from high-dose hMG stimulation; their reproductive outcome is poor.