Bromocriptine method associated with ovarian stimulation in poor responder patients - Revista Brasileira de Ginecologia e Obstetrícia

OBJECTIVE: to assess the ovarian response of poor responsive patients, submitted to the bromocriptine method. PACIENTS AND METHODS: a prospective clinical trial for the in vitro fertilization (IVF) program was performed in 10 poor responsive patients. Endocrinologically normal ovulatory women under 38 years old, who had previously failed in IVF due to poor response to ovarian stimulation with the traditional protocol, were submitted to the bromocriptine method in 12 cycles. They were given bromocriptine, a dopaminergic agonist, in the preceding cycle in order to stop the prolactin production. When the medication was removed at the beginning of the stimulation cycle, an elevation of seric prolactin by a rebound phenomenon was found. This optimized its seric concentration, improving the quality of oocytes and embryos. Serum prolactin and estradiol concentrations, number of follicles, number and quality of oocytes and cleaved embryos, fertilization and pregnancy rates were analyzed. RESULTS: there was a reduction in the dose of gonadotropin administered and in the duration of ovarian stimulation and an improvement in follicular recruitment, oocyte retrieval, embryo morphology, fertilization, and ongoing pregnancy rates. Fertilization rate was 77.7%, pregnancy rate was 44.4% and live baby rate was 25%. CONCLUSION: this study suggests that the bromocriptine method enhanced follicular recruitment and embryonic development, resulting in increased fertilization and pregnancy rates when compared with the traditional protocol for poor responsive patients. Studies with a large number of patients are necessary to confirm these results.