The Study Of Modified Prolonged Down-regulation Protocol Used In Poor Ovarian Responders Undergoing IVF-ET

poor ovarian responder is one of the difficult problems in assisted reproductive technology treatment. The mobidity is9%～24%during the ART patients, poor ovarian responder is a pathological condition that show low reaction to Gn. Few oocytes retrieved, low quality oocytes, heterogeneity between follicle and endometrium and low clinical pregnancy rate were the main expressions. The decreased function of follicle reserve is the main reason that cause poor ovarian responder. The use of rationalization protocol to improve the quality of oocyte and microenvironment of embryo inbed is a key step to solve this problem. Now,there are many protocols used for patients with poor ovarian responder, such as long protocol, antagonist protocol, short protocol, microstimulation protocol et al, every protocol has its advantage and disadvantage. Modified prolonged down-regulation protocol Retrospective study show modified prolonged down-regulation protocol can improve the clinical pregnancy remarkablely. In order to detect the effectiveness and probable mechanism of modified prolonged down-regulation protocol, we have this study.The contents and results of this study contain three sections:①The results of treatment between the modified prolonged down-regulation protocol and the short protocol, modified prolonged down-regulation protocol and the antagonist protocol were analyzed retrospectively. The day of Gn were longer in modified prolonged down-regulation protocol than short protocol,with significant difference (P<0.05) the clinical pregnancy rate of modified prolonged down-regulation protocol was statistically higher than that of short protocol (P<0.05).The same patient,achieved compared high pregnancy rate with modified prolonged down-regulation protocol. The days of stimulation were longer in the modified prolonged down-regulation protocol than in the short protocol with significant difference (P<0.05), the rate of high quality embryo and cycle cancellation were higher in the modified prolonged down regulation protocol than in the short protocol with significant difference (P<0.05).②The Study of the Relationship between the Level of Stem Cell Factor in Human Follicular Fluid and the Influence on Oocyte Development and Fertilization. SCF level of follicle fluid with matured oocytes,fertilization oocytes and high quality embryos is much higher than that with unmatured oocytes, unfertilization oocyteslow and low quality embryos(P<0.05).③The retrospective study of modified prolonged down regulation protocol, used for poor ovarian responder patients undergoing IVF-ET treatment. The rate of high quatity embryo, levels of stem cell factor (SCF) and cumulative clinical pregnancy rates of modified prolonged down regulation protocol group were much higher than that of antagonist protocol and long protocol groups (P<0.05). The follicle heterogeneity rate on D7and the levels of E2and T in follicle fluid of modified prolonged down regulation protocol group were much lower than that of antagonist protocol and long protocol groups (P<0.05) The days of stimulation, total ampules of Gn, clinical pregnancy rate of fresh cycle and cycle cancellation rate of modified prolonged down regulation protocol group were improved remarkblely than that of antagonist protocol group only (P<0.05)The following conclusions can be made from this study:①SCF of human follicular fluid is from ovary, not from serum, the level of the follicular fluid SCF has the same trends with the ability of oocyte fertilization and development, it is one of the effective cell factor that can evaluate the quality of oocyte.②The improving of the oocyte quality is one of the mechanism that the modified prolonged down-regulation protocol can improve the result of clinical pregnancy of poor ovarian response patients, and the protocol may be one of the ovarian hyperstimulation protocols that the first time used for poor ovarian response patients.