AUTHOR=Takeuchi Kazuhiro , Orita Yuji , Iwakawa Tokiko , Kuwatsuru Yukari , Kuroki Yuko , Fukumoto Yumiko , Mizobe Yamato , Tokudome Mari , Moewaki Harue TITLE=Original delayed-start ovarian stimulation protocol with a gonadotropin-releasing hormone antagonist, medroxyprogesterone acetate, and high-dose gonadotropin for poor responders and patients with poor-quality embryos JOURNAL=Frontiers in Endocrinology VOLUME=Volume 14 - 2023 YEAR=2023 URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1277873 DOI=10.3389/fendo.2023.1277873 ISSN=1664-2392 ABSTRACT=Low response to ovarian stimulation is a crucial problem in poor responders and patients with poorquality embryos. The delayed-start gonadotropin-releasing hormone antagonist protocol seems effective for poor responders to overcome this problem, but there are insufficient data on whether it is also effective for patients with poor-quality embryos. This study described the efficiency of this protocol for both poor responders and patients with poor-quality embryo. This protocol increased the number of MⅡ oocytes retrieved, 2PN zygotes, good blastocysts, and lead to improve live birth rates in both poor responders and patients with poor-quality embryos. It is certain that administration of GnRH antagonist contribute to synchronized follicular development and increase the number of mature oocyte. In addition, this study indicates that administration of GnRH antagonist in early follicular phase improve the quality of the oocyte.