In vitro fertilization with low-dose clomiphene citrate stimulation in women who respond poorly to superovulation

Purpose: Our experience with NF using low-dose clomiphene citrate for stimulation in ''non-'' and ''poor'' responders was reviewed and the treatment outcomes with the previous controlled ovarian stimulation cycles in which hMG and GnRH agonist were used were compared. Methods: The treatment outcome in II non-and 20 poor responders having 30 and 53 clomiphene citrate NF treatment cycles, respectively, were compared with the treatment outcome in the previous long-protocol buserelin/hMG cycles. Results: The clinical pregnancy rates per oocyte collection achieved in the first clomiphene citrate cycle in non (9.1%)- and poor (10%) responders were comparable to those achieved by poor responders (11.9%) who had buserelin/hMG using the long protocol, Although the numbers were small, a similar pregnancy rate could still be achieved in poor responders up to the third attempt using clomiphene citrate, Conclusions: NF using long-protocol buserelin/hMG is more successful than using clomiphene citrate stimulation. However, this advantage may not be significant in those women with a previous poor response to buserelin/hMG. It is suggested that for such poor responders, three attempts of IVF in a clomiphene citrate cycle may offer a viable therapeutic alternative before reverting to more stressful, expensive, and time-consuming treatment.