Mohamed 2006.
| Methods | RCT | |
| Participants | 30 women Inclusion criteria: known to be low responders (developed fewer than six follicles > 12 mm in previous IVF cycles under the standard mid‐luteal phase down‐regulation protocol) Exclusion criteria: abnormally high FSH > 13 IU/l Setting and timing: centre for assisted conception, UK. timing not specified Baseline characteristics: age agonist group 37 (95% CI 35 to 39) vs antagonist group 36 (95% CI 33.5 to 38) |
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| Interventions |
Agonist group ‐ 500 micrograms buserelin SC daily starting day 1 of menstrual cycle Antagonist group ‐ cetrorelix 0.25 mg SC daily started on cycle day 8 and continued until day of hCG injection Ovarian stimulation started on cycle day 3 with 225 to 375 IU gonadotrophin daily based on highest dose reached in previous IVF cycle Both buserelin and gonadotrophin continued until day of hCG 10,000 IU injection Gonadotrophin increased by 75 IU/day if fewer than three follicles measuring 12 mm or more were found on cycle day 9 Luteal support ‐ progesterone used for luteal support 400 mg twice daily Number of ampoules ‐ agonist 44.5 (95% CI 38.5 to 54) vs antagonist group 35.5 (95% CI 33 to 41) |
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| Outcomes | Serum LH and E2 levels, cycle cancellation | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | "randomised" but no other details |
| Allocation concealment (selection bias) | Unclear risk | Sealed envelopes used but no details as to whether opaque or given out sequentially |
| Blinding (performance bias and detection bias) All outcomes | Unclear risk | No details but blinding unlikely. The lack of blinding is unlikely to effect the fertility outcomes |
| Incomplete outcome data (attrition bias) All outcomes | Unclear risk | Two women not analysed from 30 women randomised due to cycle cancellation. Both were in the antagonist group |
| Selective reporting (reporting bias) | Unclear risk | No pregnancy outcomes of relevance were reported. The primary outcomes relate to serum LH and E2 levels Cycle cancellation was reported but was not pre‐specified as an outcome |
| Other bias | Low risk | No other bias identified, groups were balanced at baseline |