Forty-eight patients who met the criteria of poor response during prior gonadotropin stimulation were enrolled in a randomized prospective study comparing a gonadotropin-releasing hormone (GnRH) antagonist protocol, using ganirelix acetate, with a microdose GnRH agonist protocol for in vitro fertilization-embryo transfer (IVF-ET). This pilot study contributes to the literature of poor response IVF treatment protocols because the use of ganirelix appears to be as effective as the microdose protocol and may be a superior choice in terms of cost and convenience for the patient.