The effect of gonadotropin gap for non-growing follicles in poor ovarian response: Might this be a new strategy?

Objective: Cessation of gonadotropin stimulation might affect follicular growth in patients in POSEIDON groups 3 and 4, which are unresponsive to high-dose stimulation. Materials and Methods: In this retrospective study, data were extracted from the medical records of patients treated at the Acıbadem Maslak Hospital Assisted Reproductive Technologies Unit between November 2010 and December 2020. Eighty-five patients who fulfilled the inclusion criteria were included in the study. Gonadotropin stimulation was discontinued if the follicle diameter increased by 2 mm within 7 days after the initiation of stimulation in patients in groups 3 and 4. The outcomes of the treatment strategy and pregnancy were recorded. Results: Follicular growth was observed in 40% (34/85) of patients, of whom 52.9% (18/34) had 2pn embryos. Ten of the 85 patients (11.8%) underwent embryo transfer, resulting in biochemical pregnancy for two patients and healthy live birth for one patient. Conclusion: When high-dose stimulation is ineffective, discontinuing gonadotropin administration during ovarian stimulation may provide patients with the opportunity to conceive using their own biological oocytes. To the best of our knowledge, this is the first study to report a live birth rate using this strategy.