Dopamine D-2 Antagonist Use in Poor Responders in IVF: a Randomized Controlled Trial
Status:
Unknown status
Trial end date:
2018-03-01
Target enrollment:
Participant gender:
Summary
Metoclopramide is a dopamine D2 receptor antagonist with antiemetic and gastrokinetic
properties which has been approved for use in pregnant women. Women with polycystic ovary
syndrome (PCOS) have been found to have lower dopaminergic tone and increased ovarian
vascularity and vascular endothelial growth factor (VEGF) levels compared to controls. During
ovarian stimulation, PCOS patients exhibit greater sensitivity to gonadotropins and increased
follicular development. Administration of dopamine D2 antagonists may mimic the low
dopaminergic tone noted in PCOS patients, increase VEGF levels, angiogenesis, and
subsequently improve follicular growth during ovarian stimulation. This strategy could be
used to improve IVF outcomes in poor responders.
The investigators hypothesize that, compared to gonadotropin use alone, the use of
metoclopramide in combination with gonadotropins in poor responders undergoing IVF will
result in an increased number of mature oocytes obtained at oocyte retrieval and improved IVF
outcomes.