Role of gonadotropin-releasing hormone antagonists in poor responders

Fertility and Sterility

Volumn 87, Issue 2, 2007, Pages 241-249

  Mahutte, Neal G ^a   Arici, Aydin ^b  

^a DARTMOUTH MEDICAL SCHOOL   (United States)

^b YALE UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

antral follicle count; controlled ovarian hyperstimulation; GnRH antagonists; in vitro fertilization; poor responders

Indexed keywords

BUSERELIN; CETRORELIX; CLOMIFENE CITRATE; ESTROGEN; FOLLITROPIN; GANIRELIX; GONADORELIN AGONIST; GONADORELIN ANTAGONIST; GONADOTROPIN; GONADOTROPIN DERIVATIVE; LEUPRORELIN; LUTEINIZING HORMONE; LUTEINIZING HORMONE RECEPTOR; RECOMBINANT FOLLITROPIN; RECOMBINANT LUTEINIZING HORMONE;

CLINICAL PROTOCOL; CLINICAL TRIAL; COST; ENDOMETRIUM; ESTROGEN BLOOD LEVEL; FEMALE; FERTILIZATION; FERTILIZATION IN VITRO; FOLLITROPIN BLOOD LEVEL; HORMONAL REGULATION; HUMAN; INTRACYTOPLASMIC SPERM INJECTION; MENSTRUAL CYCLE; NIDATION; OOCYTE; OUTCOME ASSESSMENT; OVARY FOLLICLE; OVARY HYPERSTIMULATION; PREGNANCY RATE; PRIORITY JOURNAL; REVIEW; SYSTEMATIC REVIEW;

CLINICAL TRIALS; FEMALE; FERTILIZATION IN VITRO; GONADOTROPIN-RELEASING HORMONE; HORMONE ANTAGONISTS; HUMANS; INFERTILITY, FEMALE; OVULATION INDUCTION; PREGNANCY; PREGNANCY OUTCOME; TREATMENT FAILURE; TREATMENT OUTCOME;

EID: 33846636012     PISSN: 00150282     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.fertnstert.2006.07.1457     Document Type: Review

References (88)

1. Somigliana E., Ragni G., Infantino M., Benedetti F., Arnoldi M., and Crosignani P.G. Does laparoscopic removal of nonendometriotic benign ovarian cysts affect ovarian reserve?. Acta Obstet Gynecol Scand 85 (2006) 74-77
2. Ragni G., Somigliana E., Benedetti F., Paffoni A., Vegetti W., Restelli L., et al. Damage to ovarian reserve associated with laparoscopic excision of endometriomas: a quantitative rather than a qualitative injury. Am J Obstet Gynecol 193 (2005) 1908-1914
3. Garcia-Velasco J.A., Mahutte N.G., Corona J., Zuniga V., Giles J., Arici A., et al. Removal of endometriomas before in vitro fertilization does not improve fertility outcomes: a matched, case-control study. Fertil Steril 81 (2004) 1194-1197
4. Exacoustos C., Zupi E., Amadio A., Szabolcs B., De Vivo B., Marconi D., et al. Laparoscopic removal of endometriomas: sonographic evaluation of residual functioning ovarian tissue. Am J Obstet Gynecol 191 (2004) 68-72
5. Somigliana E., Ragni G., Benedetti F., Borroni R., Vegetti W., and Crosignani P.G. Does laparoscopic excision of endometriotic ovarian cysts significantly affect ovarian reserve?. Insights from IVF cycles. Hum Reprod 18 (2003) 2450-2453
6. Ho H.Y., Lee R.K., Hwu Y.M., Lin M.H., Su J.T., and Tsai Y.C. Poor response of ovaries with endometrioma previously treated with cystectomy to controlled ovarian hyperstimulation. J Assist Reprod Genet 19 (2002) 507-511
7. Diedrich K., Diedrich C., Santos E., Zoll C., al-Hasani S., Reissmann T., et al. Suppression of the endogenous luteinizing hormone surge by the gonadotrophin-releasing hormone antagonist cetrorelix during ovarian stimulation. Hum Reprod 9 (1994) 788-791
8. Crosignani P.G., Ragni G., Lombroso G.C., Scarduelli C., de Lauretis L., Caccamo A., et al. IVF: induction of ovulation in poor responders. J Steroid Biochem 32 (1989) 171-173
9. Hofmann G.E., Toner J.P., Muasher S.J., and Jones G.S. High-dose follicle-stimulating hormone (FSH) ovarian stimulation in low-responder patients for in vitro fertilization. J In Vitro Fert Embryo Transfer 6 (1989) 285-289
10. Karande V.C., Jones G.S., Veeck L.L., and Muasher S.J. High-dose follicle-stimulating hormone stimulation at the onset of the menstrual cycle does not improve the in vitro fertilization outcome in low-responder patients. Fertil Steril 53 (1990) 486-489
11. Manzi D.L., Thornton K.L., Scott L.B., and Nulsen J.C. The value of increasing the dose of human menopausal gonadotropins in women who initially demonstrate a poor response. Fertil Steril 62 (1994) 251-256
12. Land J.A., Yarmolinskaya M.I., Dumoulin J.C., and Evers J.L. High-dose human menopausal gonadotropin stimulation in poor responders does not improve in vitro fertilization outcome. Fertil Steril 65 (1996) 961-965
13. Klinkert E.R., Broekmans F.J., Looman C.W., Habbema J.D., and te Velde E.R. Expected poor responders on the basis of an antral follicle count do not benefit from a higher starting dose of gonadotrophins in IVF treatment: a randomized controlled trial. Hum Reprod 20 (2005) 611-615
14. Hugues J.N., and Cedrin Durnerin I.C. Revisiting gonadotrophin-releasing hormone agonist protocols and management of poor ovarian responses to gonadotrophins. Hum Reprod Update 4 (1998) 83-101
15. Ben-Rafael Z., Lipitz S., Bider D., and Mashiach S. Ovarian hyporesponsiveness in combined gonadotropin-releasing hormone agonist and menotropin therapy is associated with low serum follicle-stimulating hormone levels. Fertil Steril 55 (1991) 272-275
16. Latouche J., Crumeyrolle-Arias M., Jordan D., Kopp N., Augendre-Ferrante B., Cedard L., et al. GnRH receptors in human granulosa cells: anatomical localization and characterization by autoradiographic study. Endocrinology 125 (1989) 1739-1741
17. Janssens R.M., Brus L., Cahill D.J., Huirne J.A., Schoemaker J., and Lambalk C.B. Direct ovarian effects and safety aspects of GnRH agonists and antagonists. Hum Reprod Update 6 (2000) 505-518
18. Leung P.C., Cheng C.K., and Zhu X.M. Multi-factorial role of GnRH-I and GnRH-II in the human ovary. Mol Cell Endocrinol 202 (2003) 145-153
19. Kowalik A., Barmat L., Damario M., Liu H.C., Davis O., and Rosenwaks Z. Ovarian estradiol production in vivo. Inhibitory effect of leuprolide acetate. J Reprod Med 43 (1998) 413-417
20. Feldberg D., Farhi J., Ashkenazi J., Dicker D., Shalev J., and Ben-Rafael Z. Minidose gonadotropin-releasing hormone agonist is the treatment of choice in poor responders with high follicle-stimulating hormone levels. Fertil Steril 62 (1994) 343-346
21. Olivennes F., Righini C., Fanchin R., Torrisi C., Hazout A., Glissant M., et al. A protocol using a low dose of gonadotrophin-releasing hormone agonist might be the best protocol for patients with high follicle-stimulating hormone concentrations on day 3. Hum Reprod 11 (1996) 1169-1172
22. Garcia-Velasco J.A., Isaza V., Requena A., Martinez-Salazar F.J., Landazabal A., Remohi J., et al. High doses of gonadotrophins combined with stop versus non-stop protocol of GnRH analogue administration in low responder IVF patients: a prospective, randomized, controlled trial. Hum Reprod 15 (2000) 2292-2296
23. Faber B.M., Mayer J., Cox B., Jones D., Toner J.P., Oehninger S., et al. Cessation of gonadotropin-releasing hormone agonist therapy combined with high-dose gonadotropin stimulation yields favorable pregnancy results in low responders. Fertil Steril 69 (1998) 826-830
24. Dirnfeld M., Fruchter O., Yshai D., Lissak A., Ahdut A., and Abramovici H. Cessation of gonadotropin-releasing hormone analogue (GnRH-a) upon down-regulation versus conventional long GnRH-a protocol in poor responders undergoing in vitro fertilization. Fertil Steril 72 (1999) 406-411
25. Scott R.T., and Navot D. Enhancement of ovarian responsiveness with microdoses of gonadotropin-releasing hormone agonist during ovulation induction for in vitro fertilization. Fertil Steril 61 (1994) 880-885
26. Surrey E.S., Bower J., Hill D.M., Ramsey J., and Surrey M.W. Clinical and endocrine effects of a microdose GnRH agonist flare regimen administered to poor responders who are undergoing in vitro fertilization. Fertil Steril 69 (1998) 419-424
27. Schoolcraft W., Schlenker T., Gee M., Stevens J., and Wagley L. Improved controlled ovarian hyperstimulation in poor responder in vitro fertilization patients with a microdose follicle-stimulating hormone flare, growth hormone protocol. Fertil Steril 67 (1997) 93-97
28. Halmos G., and Schally A.V. Changes in subcellular distribution of pituitary receptors for luteinizing hormone-releasing hormone (LH-RH) after treatment with the LH-RH antagonist cetrorelix. Proc Natl Acad Sci USA 99 (2002) 961-965
29. Kovacs M., Schally A.V., Csernus B., and Rekasi Z. Luteinizing hormone-releasing hormone (LH-RH) antagonist cetrorelix down-regulates the mRNA expression of pituitary receptors for LH-RH by counteracting the stimulatory effect of endogenous LH-RH. Proc Natl Acad Sci USA 98 (2001) 1829-1834
30. Griesinger G., Felberbaum R.E., Schultze-Mosgau A., and Diedrich K. Gonadotropin-releasing hormone antagonists for assisted reproductive techniques: are there clinical differences between agents?. Drugs 64 (2004) 563-575
31. Borm G., and Mannaerts B. Treatment with the gonadotrophin-releasing hormone antagonist ganirelix in women undergoing ovarian stimulation with recombinant follicle stimulating hormone is effective, safe and convenient: results of a controlled, randomized, multicentre trial. The European Orgalutran Study Group. Hum Reprod 15 (2000) 1490-1498
32. Olivennes F., Belaisch-Allart J., Emperaire J.C., Dechaud H., Alvarez S., Moreau L., et al. Prospective, randomized, controlled study of in vitro fertilization-embryo transfer with a single dose of a luteinizing hormone-releasing hormone (LH-RH) antagonist (cetrorelix) or a depot formula of an LH-RH agonist (triptorelin). Fertil Steril 73 (2000) 314-320
33. European and Middle East Orgalutran Study Group. Comparable clinical outcome using the GnRH antagonist ganirelix or a long protocol of the GnRH agonist triptorelin for the prevention of premature LH surges in women undergoing ovarian stimulation. Hum Reprod 16 (2001) 644-651
34. Ludwig M., Felberbaum R.E., Devroey P., Albano C., Riethmuller-Winzen H., Schuler A., et al. Significant reduction of the incidence of ovarian hyperstimulation syndrome (OHSS) by using the LHRH antagonist cetrorelix (Cetrotide) in controlled ovarian stimulation for assisted reproduction. Arch Gynecol Obstet 264 (2000) 29-32
35. Olivennes F., Cunha-Filho J.S., Fanchin R., Bouchard P., and Frydman R. The use of GnRH antagonists in ovarian stimulation. Hum Reprod Update 8 (2002) 279-290
36. Vlaisavljevic V., Reljic M., Lovrec V.G., and Kovacic B. Comparable effectiveness using flexible single-dose GnRH antagonist (cetrorelix) and single-dose long GnRH agonist (goserelin) protocol for IVF cycles-a prospective, randomized study. Reprod Biomed Online 7 (2003) 301-308
37. Loutradis D., Stefanidis K., Drakakis P., Milingos S., Antsaklis A., and Michalas S. A modified gonadotropin-releasing hormone (GnRH) antagonist protocol failed to increase clinical pregnancy rates in comparison with the long GnRH protocol. Fertil Steril 82 (2004) 1446-1448
38. Xavier P., Gamboa C., Calejo L., Silva J., Stevenson D., Nunes A., et al. A randomised study of GnRH antagonist (cetrorelix) versus agonist (busereline) for controlled ovarian stimulation: effect on safety and efficacy. Eur J Obstet Gynecol Reprod Biol 120 (2005) 185-189
39. Al-Inany H., and Aboulghar M. GnRH antagonist in assisted reproduction: a Cochrane review. Hum Reprod 17 (2002) 874-885
40. Hernandez E.R. Embryo implantation and GnRH antagonists: embryo implantation: the Rubicon for GnRH antagonists. Hum Reprod 15 (2000) 1211-1216
41. Ortmann O., Weiss J.M., and Diedrich K. Embryo implantation and GnRH antagonists: ovarian actions of GnRH antagonists. Hum Reprod 16 (2001) 608-611
42. Gordon K. Gonadotropin-releasing hormone antagonists implications for oocyte quality and uterine receptivity. Ann NY Acad Sci 943 (2001) 49-54
43. Garcia-Velasco J.A., Isaza V., Vidal C., Landazabal A., Remohi J., Simon C., et al. Human ovarian steroid secretion in vivo: effects of GnRH agonist versus antagonist (cetrorelix). Hum Reprod 16 (2001) 2533-2539
44. Saadat P., Boostanfar R., Slater C.C., Tourgeman D.E., Stanczyk F.Z., and Paulson R.J. Accelerated endometrial maturation in the luteal phase of cycles utilizing controlled ovarian hyperstimulation: impact of gonadotropin-releasing hormone agonists versus antagonists. Fertil Steril 82 (2004) 167-171
45. Mirkin S., Nikas G., Hsiu J.G., Diaz J., and Oehninger S. Gene expression profiles and structural/functional features of the peri-implantation endometrium in natural and gonadotropin-stimulated cycles. J Clin Endocrinol Metab 89 (2004) 5742-5752
46. Lindheim S.R., and Morales A.J. GnRH antagonists followed by a decline in serum estradiol results in adverse outcomes in donor oocyte cycles. Hum Reprod 18 (2003) 2048-2051
47. Griesinger G., Finas D., Alisch A., Roiha K., Schultze-Mosgau A., Schroder A.K., et al. FSH time-concentration profiles before and after administration of 0.25 mg cetrorelix in the GnRH-antagonist multiple-dose protocol for ovarian hyperstimulation. J Assist Reprod Genet 21 (2004) 279-282
48. Aboulghar M.A., Mansour R.T., Serour G.I., Al-Inany H.G., Amin Y.M., and Aboulghar M.M. Increasing the dose of human menopausal gonadotrophins on day of GnRH antagonist administration: randomized controlled trial. Reprod Biomed Online 8 (2004) 524-527
49. Ludwig M., Katalinic A., Banz C., Schroder A.K., Loning M., Weiss J.M., et al. Tailoring the GnRH antagonist cetrorelix acetate to individual patients' needs in ovarian stimulation for IVF: results of a prospective, randomized study. Hum Reprod 17 (2002) 2842-2845
50. Mochtar M.H. The effect of an individualized GnRH antagonist protocol on folliculogenesis in IVF/ICSI. Hum Reprod 19 (2004) 1713-1718
51. Kolibianakis E.M., Albano C., Kahn J., Camus M., Tournaye H., Van Steirteghem A.C., et al. Exposure to high levels of luteinizing hormone and estradiol in the early follicular phase of gonadotropin-releasing hormone antagonist cycles is associated with a reduced chance of pregnancy. Fertil Steril 79 (2003) 873-880
52. Escudero E., Bosch E., Crespo J., Simon C., Remohi J., and Pellicer A. Comparison of two different starting multiple dose gonadotropin-releasing hormone antagonist protocols in a selected group of in vitro fertilization-embryo transfer patients. Fertil Steril 81 (2004) 562-566
53. Young K.A., Chaffin C.L., Molskness T.A., and Stouffer R.L. Controlled ovulation of the dominant follicle: a critical role for LH in the late follicular phase of the menstrual cycle. Hum Reprod 18 (2003) 2257-2263
54. Filicori M., Cognigni G.E., Samara A., Melappioni S., Perri T., Cantelli B., et al. The use of LH activity to drive folliculogenesis: exploring uncharted territories in ovulation induction. Hum Reprod Update 8 (2002) 543-557
55. Filicori M., Cognigni G.E., Taraborrelli S., Spettoli D., Ciampaglia W., de Fatis C.T., et al. Luteinizing hormone activity supplementation enhances follicle-stimulating hormone efficacy and improves ovulation induction outcome. J Clin Endocrinol Metab 84 (1999) 2659-2663
56. Filicori M., Cognigni G.E., Tabarelli C., Pocognoli P., Taraborrelli S., Spettoli D., et al. Stimulation and growth of antral ovarian follicles by selective LH activity administration in women. J Clin Endocrinol Metab 87 (2002) 1156-1161
57. Sullivan M.W., Stewart-Akers A., Krasnow J.S., Berga S.L., and Zeleznik A.J. Ovarian responses in women to recombinant follicle-stimulating hormone and luteinizing hormone (LH): a role for LH in the final stages of follicular maturation. J Clin Endocrinol Metab 84 (1999) 228-232
58. Filicori M., Cognigni G.E., Pocognoli P., Ciampaglia W., and Bernardi S. Current concepts and novel applications of LH activity in ovarian stimulation. Trends Endocrinol Metab 14 (2003) 267-273
59. Acevedo B., Sanchez M., Gomez J.L., Cuadros J., Ricciarelli E., and Hernandez E.R. Luteinizing hormone supplementation increases pregnancy rates in gonadotropin-releasing hormone antagonist donor cycles. Fertil Steril 82 (2004) 343-347
60. Griesinger G., Schultze-Mosgau A., Dafopoulos K., Schroeder A., Schroer A., von Otte S., et al. Recombinant luteinizing hormone supplementation to recombinant follicle-stimulating hormone induced ovarian hyperstimulation in the GnRH-antagonist multiple-dose protocol. Hum Reprod 83 (2005) 452-454
61. Cedrin-Durnerin I., Grange-Dujardin D., Laffy A., Parneix I., Massin N., Galey J., et al. Recombinant human LH supplementation during GnRH antagonist administration in IVF/ICSI cycles: a prospective randomized study. Hum Reprod 19 (2004) 1979-1984
62. Humaidan P., Bungum M., Bungum L., and Yding Andersen C. Effects of recombinant LH supplementation in women undergoing assisted reproduction with GnRH agonist down-regulation and stimulation with recombinant FSH: an opening study. Reprod Biomed Online 8 (2004) 635-643
63. Chung K., Krey L., Katz J., and Noyes N. Evaluating the role of exogenous luteinizing hormone in poor responders undergoing in vitro fertilization with gonadotropin-releasing hormone antagonists. Fertil Steril 84 (2005) 313-318
64. Kolibianakis E.M., Tarlatzis B., and Devroey P. GnRH antagonists in IVF. Reprod Biomed Online 10 (2005) 705-712
65. Craft I., Gorgy A., Hill J., Menon D., and Podsiadly B. Will GnRH antagonists provide new hope for patients considered "difficult responders" to GnRH agonist protocols?. Hum Reprod 14 (1999) 2959-2962
66. Nikolettos N., Al-Hasani S., Felberbaum R., Demirel L.C., Kupker W., Montzka P., et al. Gonadotropin-releasing hormone antagonist protocol: a novel method of ovarian stimulation in poor responders. Eur J Obstet Gynecol Reprod Biol 97 (2001) 202-207
67. Mohamed K.A., Davies W.A., Allsopp J., and Lashen H. Agonist "flare-up" versus antagonist in the management of poor responders undergoing in vitro fertilization treatment. Fertil Steril 83 (2005) 331-335
68. Akman M.A., Erden H.F., Tosun S.B., Bayazit N., Aksoy E., and Bahceci M. Comparison of agonistic flare-up-protocol and antagonistic multiple dose protocol in ovarian stimulation of poor responders: results of a prospective randomized trial. Hum Reprod 16 (2001) 868-870
69. Schmidt D.W., Bremner T., Orris J.J., Maier D.B., Benadiva C.A., and Nulsen J.C. A randomized prospective study of microdose leuprolide versus ganirelix in in vitro fertilization cycles for poor responders. Fertil Steril 83 (2005) 1568-1571
70. Cheung L.P., Lam P.M., Lok I.H., Chiu T.T., Yeung S.Y., Tjer C.C., et al. GnRH antagonist versus long GnRH agonist protocol in poor responders undergoing IVF: a randomized controlled trial. Hum Reprod 20 (2005) 616-621
71. Akman M.A., Erden H.F., Tosun S.B., Bayazit N., Aksoy E., and Bahceci M. Addition of GnRH antagonist in cycles of poor responders undergoing IVF. Hum Reprod 15 (2000) 2145-2147
72. Scott Jr. R.T., Hofmann G.E., Oehninger S., and Muasher S.J. Intercycle variability of day 3 follicle-stimulating hormone levels and its effect on stimulation quality in in vitro fertilization. Fertil Steril 54 (1990) 297-302
73. Hannoun A., Abu Musa A., Awwad J., Kaspar H., and Khalil A. Clomiphene citrate challenge test: cycle to cycle variability of cycle day 10 follicle stimulating hormone level. Clin Exp Obstet Gynecol 25 (1998) 155-156
74. Kwee J., Schats R., McDonnell J., Lambalk C.B., and Schoemaker J. Intercycle variability of ovarian reserve tests: results of a prospective randomized study. Hum Reprod 19 (2004) 590-595
75. Scheffer G.J., Broekmans F.J., Dorland M., Habbema J.D., Looman C.W., and te Velde E.R. Antral follicle counts by transvaginal ultrasonography are related to age in women with proven natural fertility. Fertil Steril 72 (1999) 845-851
76. Bancsi L.F., Broekmans F.J., Looman C.W., Habbema J.D., and te Velde E.R. Impact of repeated antral follicle counts on the prediction of poor ovarian response in women undergoing in vitro fertilization. Fertil Steril 81 (2004) 35-41
77. Tomas C., Nuojua-Huttunen S., and Martikainen H. Pretreatment transvaginal ultrasound examination predicts ovarian responsiveness to gonadotrophins in in-vitro fertilization. Hum Reprod 12 (1997) 220-223
78. Chang M.Y., Chiang C.H., Hsieh T.T., Soong Y.K., and Hsu K.H. Use of the antral follicle count to predict the outcome of assisted reproductive technologies. Fertil Steril 69 (1998) 505-510
79. Ng E.H., Tang O.S., and Ho P.C. The significance of the number of antral follicles prior to stimulation in predicting ovarian responses in an IVF programme. Hum Reprod 15 (2000) 1937-1942
80. Frattarelli J.L., Lauria-Costab D.F., Miller B.T., Bergh P.A., and Scott R.T. Basal antral follicle number and mean ovarian diameter predict cycle cancellation and ovarian responsiveness in assisted reproductive technology cycles. Fertil Steril 74 (2000) 512-517
81. Huang F.J., Chang S.Y., Tsai M.Y., Kung F.T., Wu J.F., and Chang H.W. Determination of the efficiency of controlled ovarian hyperstimulation in the gonadotropin-releasing hormone agonist-suppression cycle using the initial follicle count during gonadotropin stimulation. J Assist Reprod Genet 18 (2001) 91-96
82. Bancsi L.F., Broekmans F.J., Eijkemans M.J., de Jong F.H., Habbema J.D., and te Velde E.R. Predictors of poor ovarian response in in vitro fertilization: a prospective study comparing basal markers of ovarian reserve. Fertil Steril 77 (2002) 328-336
83. Hansen K.R., Morris J.L., Thyer A.C., and Soules M.R. Reproductive aging and variability in the ovarian antral follicle count: application in the clinical setting. Fertil Steril 80 (2003) 577-583
84. Jurema M.W., Bracero N.J., and Garcia J.E. Fine tuning cycle day 3 hormonal assessment of ovarian reserve improves in vitro fertilization outcome in gonadotropin-releasing hormone antagonist cycles. Fertil Steril 80 (2003) 1156-1161
85. Mahutte N.G., and Arici A. Poor responders: does the protocol make a difference?. Curr Opin Obstet Gynecol 14 (2002) 275-281
86. Gianaroli L., Magli M.C., Munne S., Fiorentino A., Montanaro N., and Ferraretti A.P. Will preimplantation genetic diagnosis assist patients with a poor prognosis to achieve pregnancy?. Hum Reprod 12 (1997) 1762-1767
87. Platteau P., Staessen C., Michiels A., Van Steirteghem A., Liebaers I., and Devroey P. Preimplantation genetic diagnosis for aneuploidy screening in women older than 37 years. Fertil Steril 84 (2005) 319-324
88. Taranissi M., El-Toukhy T., and Verlinsky Y. Influence of maternal age on the outcome of PGD for aneuploidy screening in patients with recurrent implantation failure. Reprod Biomed Online 10 (2005) 628-632