{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T21:37:56Z","timestamp":1788730676632,"version":"build-2803163510"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Reprod. Health"],"abstract":"<jats:p>A 30-year-old woman with a body mass index of 20.6\u2005kg\/m\u00b2 consulted due to two years of primary infertility. The patient had a history of two unsuccessful previous rounds of ovarian stimulation for IVF due to poor ovarian response. A novel ovarian stimulation approach incorporating luteal phase estradiol priming in a stop GnRH agonist plus delta follitropin-GnRH antagonist protocol was followed. <jats:italic>in vitro<\/jats:italic> fertilization was performed resulting in eight mature oocytes, which were fertilized and developed into two usable blasts. The patient did not achieve pregnancy from either the fresh or subsequent frozen embryo transfer. Our case demonstrates that this combined strategy (estradiol and GnRH agonist) offers dual suppression of FSH and LH, with E2 playing a critical role in preventing premature FSH surges and enhancing granulosa cell receptivity. To our knowledge, this is the first study to provide initial evidence supporting the clinical utility of combining luteal E2 priming, stop GnRH agonist and follitropin delta in this context. This case report constitutes a proof of principle that requires further studies with a large number of patients to replicate and validate the stimulation protocol.<\/jats:p>","DOI":"10.3389\/frph.2025.1661353","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T05:42:14Z","timestamp":1760506934000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: E2 luteal phase priming in a stop GnRH agonist combined with GnRH antagonist using a delta follitropin protocol in a poor responder: clinical case"],"prefix":"10.3389","volume":"7","author":[{"given":"Melissa Mar\u00eda","family":"Morales Berrocal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Pe\u00f1a Miranda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armando Miguel","family":"Roque S\u00e1nchez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1616","DOI":"10.1093\/humrep\/der092","article-title":"ESHRE consensus on the definition of \u2018poor response to ovarian stimulation for in vitro fertilization: the Bologna criteria","volume":"26","author":"Ferraretti","year":"2011","journal-title":"Hum Reprod"},{"key":"B2","doi-asserted-by":"publisher","first-page":"182","DOI":"10.3389\/fendo.2020.00182","article-title":"Stop GnRH-agonist combined with multiple-dose GnRH-antagonist protocol for patients with \u201cgenuine\u201d poor response undergoing controlled ovarian hyperstimulation for IVF","volume":"11","author":"Orvieto","year":"2020","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B3","doi-asserted-by":"crossref","DOI":"10.1016\/j.fertnstert.2022.02.026","volume-title":"Managing Poor Ovarian Response in the Patient with Diminished Ovarian Reserve","author":"Cedars","year":"2022"},{"key":"B4","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1186\/1477-7827-11-96","article-title":"Cycle scheduling for in vitro fertilization with oral contraceptive pills versus oral estradiol valerate: a randomized, controlled trial","volume":"11","author":"Hauzman","year":"2013","journal-title":"Reprod Biol Endocrinol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1007\/s10815-011-9685-7","article-title":"Effect of estrogen priming through luteal phase and stimulation phase in poor responders in in vitro fertilization","volume":"29","author":"Chang","year":"2012","journal-title":"J Assist Reprod Genet"},{"key":"B6","volume-title":"Pituitary Suppression with Gonadotropin-Releasing Hormone Agonist Prior to Artificial Endometrial Preparation in Frozen\u2013Thawed Embryo Transfer Cycles: A Systematic Review and Meta-Analysis of Different Protocols and Infertile Populations","author":"Ho","year":"2024"},{"key":"B7","article-title":"The effects of different gonadotropin releasing hormone analogues in IVF cycles","author":"Fi\u00e7icio\u011flu","year":""},{"key":"B8","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1016\/j.fertnstert.2020.09.158","article-title":"Individualized ovarian stimulation for in vitro fertilization: a multicenter, open label, exploratory study with a mixed protocol of follitropin delta and highly purified human menopausal gonadotropin","volume":"115","author":"Bissonnette","year":"2021","journal-title":"Fertil Steril"},{"key":"B9","article-title":"REKOVELLE, INN-follitropin delta","year":""},{"key":"B10","doi-asserted-by":"publisher","first-page":"5202","DOI":"10.3390\/jcm12165202","article-title":"Inadvertent administration of 72 \u00b5g of follitropin-\u0394 for three consecutive days does not appear to be dangerous for poor responders: a case series","volume":"12","author":"Baldini","year":"2023","journal-title":"J Clin Med"}],"container-title":["Frontiers in Reproductive Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frph.2025.1661353\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T05:42:16Z","timestamp":1760506936000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frph.2025.1661353\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,15]]},"references-count":10,"alternative-id":["10.3389\/frph.2025.1661353"],"URL":"https:\/\/doi.org\/10.3389\/frph.2025.1661353","relation":{},"ISSN":["2673-3153"],"issn-type":[{"value":"2673-3153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,15]]},"article-number":"1661353"}}