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Zivi E, Eldar-Geva T, Rubinstein E, Dekel N, Schonberger O, Ben-Ami I. Impact of pre-treatment in GnRH-antagonist cycles triggered with GnRH agonist on reproductive outcomes. JBRA Assist Reprod 2024; 28:2-8. [PMID: 37850846 PMCID: PMC10936906 DOI: 10.5935/1518-0557.20230022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 05/08/2023] [Indexed: 10/19/2023] Open
Abstract
OBJECTIVE Pre-treatment (PT) therapies in IVF are known to be used as pre-stimulation modality to improve cycle outcomes. This study aims to assess whether PT in GnRH antagonist cycles triggered with GnRH-agonist impact oocyte maturation response. METHODS Data were retrospectively collected for patients who underwent GnRH antagonist cycle with agonist triggering with and without PT. The patients were allocated to groups according to their PT status. The primary outcome evaluated was suboptimal maturation response. Suboptimal maturation to trigger was defined as no oocyte upon retrieval when adequate response was expected. RESULTS The study population included 196 patients who underwent GnRH antagonist cycle with agonist triggering. The study group included 69 patients who received PT. The control group included 127 patients with no PT. In univariate analysis, the PT group significantly displayed suboptimal response compared to the controls (p = 0.008). All the patients in the study group with suboptimal response (with or without hCG re-triggering) were treated with GnRH-agonist as PT. Basal and pre-trigger LH values were significantly lower in the study group compared to controls (p < 0.001). Multivariate regression analysis revealed that PT with GnRH agonist was a significant predictor for suboptimal response. CONCLUSIONS Pre-treatment, and particularly the use of GnRH-agonist as PT in antagonist cycles triggered with agonist, increases the risk of suboptimal response to GnRH-agonist trigger. This might be explained by prolonged pituitary suppression, which lasts beyond the PT cessation.
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Affiliation(s)
- Einat Zivi
- IVF and infertility Unit, Department of Obstetrics and Gynecology,
Shaare Zedek Medical Center (affiliated with the Hebrew University School of
Medicine) Jerusalem, Israel
| | - Talia Eldar-Geva
- IVF and infertility Unit, Department of Obstetrics and Gynecology,
Shaare Zedek Medical Center (affiliated with the Hebrew University School of
Medicine) Jerusalem, Israel
| | - Esther Rubinstein
- IVF and infertility Unit, Department of Obstetrics and Gynecology,
Shaare Zedek Medical Center (affiliated with the Hebrew University School of
Medicine) Jerusalem, Israel
| | - Nava Dekel
- IVF and infertility Unit, Department of Obstetrics and Gynecology,
Shaare Zedek Medical Center (affiliated with the Hebrew University School of
Medicine) Jerusalem, Israel
| | - Oshrat Schonberger
- IVF and infertility Unit, Department of Obstetrics and Gynecology,
Shaare Zedek Medical Center (affiliated with the Hebrew University School of
Medicine) Jerusalem, Israel
| | - Ido Ben-Ami
- IVF and infertility Unit, Department of Obstetrics and Gynecology,
Shaare Zedek Medical Center (affiliated with the Hebrew University School of
Medicine) Jerusalem, Israel
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Putman JM, Zhang L, Gregg AR, Testa G, Johannesson L. Clinical pregnancy rates and experience with in vitro fertilization after uterus transplantation: Dallas Uterus Transplant Study. Am J Obstet Gynecol 2021; 225:155.e1-155.e11. [PMID: 33716072 DOI: 10.1016/j.ajog.2021.02.037] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/25/2021] [Accepted: 02/27/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND The clinical pregnancy rates among patients with uterus transplantation have been reported by only a limited number of centers, and those centers have not used preimplantation genetic testing for aneuploidy in their protocol. OBJECTIVE This study examined clinical pregnancy rates among women with absolute uterine-factor infertility undergoing in vitro fertilization using good-quality, expanded-blastocyst-stage, euploid embryos after uterus transplantation. STUDY DESIGN This cohort observational study involved 20 women who underwent uterus transplantation over 3 years. Notably, 14 of these patients had successful transplants and were followed prospectively for a median of 14.1 months (range, 11-34.8 months). In vitro fertilization was performed before subjects underwent uterus transplantation, and good-quality expanded-blastocyst-stage euploid embryos were obtained and frozen for future embryo transfer. Interventions consisted of in vitro fertilization, preimplantation genetic testing for aneuploidy, uterus transplantation, and frozen embryo transfer. RESULTS All 14 subjects with successful transplants underwent single embryo transfer of a warmed, good-quality, euploid, expanded blastocyst and had at least 1 documented clinical pregnancy within the uterus. In 71.4%, the first embryo transfer resulted in clinical pregnancy. The median time from successful uterus transplantation to first embryo transfer was 4.5 months; from successful uterus transplantation to first clinical pregnancy, 7.3 months; and from successful uterus transplantation to first live birth, 14.1 months. A total of 13 live births have occurred in 12 subjects. CONCLUSION Women with absolute uterine-factor infertility who have surgically successful uterus transplantation and in vitro fertilization using preimplantation genetic testing for aneuploidy can achieve high clinical pregnancy rates. We have reduced the time interval from uterus transplantation to embryo transfer by at least 50% and the interval from uterus transplantation to clinical pregnancy by >6 months compared with previous studies. We believe our approach may shorten the time from transplant to clinical pregnancy and therefore decrease patient exposure to immunosuppressant therapies.
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Lahoud R. “When All Seems Lost”: The Ultralong Estrogen Priming (ULEP) Cycle Offers Good Pregnancy Outcomes in Poor Responder Patients. FERTILITY & REPRODUCTION 2020. [DOI: 10.1142/s266131822050005x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Treating patients with a history of poor ovarian response (POR) presents many challenges for the clinician. Poor in vitro fertilization (IVF) outcomes are a common end result. The aim of this article is to provide a detailed description of an ultralong estrogen priming (ULEP) cycle in the treatment of patients with a history of POR and to compare the outcomes to matched controls which were treated with other IVF protocols. Methods: In a retrospective study, 50 patients who meet the Bologna criteria for POR were treated with 50 ULEP cycles. The results of these cycles were compared to 50 matched controls, who were treated with other IVF protocols. Results: Patients who underwent the ULEP cycles required 3.2 more days of controlled ovarian hyperstimulation (COH) and required an extra 579 IU of follicle-stimulating hormone (FSH). The ongoing pregnancy rates per transfer were significantly greater in the ULEP group (35.1% vs. 9.1%, OR 5.4, 95% CI 1.4-21.2, p = 0.005) and per cycle started (26% vs. 6%, OR 5.5, 95% CI 1.5-20.8, p = 0.003). Conclusions: Even though the ULEP cycle is long and demanding for the patients, the outcomes suggest that this treatment regime offers a viable alternative in patients with a history of POR.
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Keane KN, Hinchliffe PM, Rowlands PK, Borude G, Srinivasan S, Dhaliwal SS, Yovich JL. DHEA Supplementation Confers No Additional Benefit to that of Growth Hormone on Pregnancy and Live Birth Rates in IVF Patients Categorized as Poor Prognosis. Front Endocrinol (Lausanne) 2018; 9:14. [PMID: 29445356 PMCID: PMC5797762 DOI: 10.3389/fendo.2018.00014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 01/12/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In vitro fertilization (IVF) patients receive various adjuvant therapies to enhance success rates, but the true benefit is actively debated. Growth hormone (GH) and dehydroepiandrosterone (DHEA) supplementation were assessed in women undergoing fresh IVF transfer cycles and categorized as poor prognosis from five criteria. METHODS Data were retrospectively analyzed from 626 women undergoing 626 IVF cycles, where they received no adjuvant, GH alone, or GH-DHEA in combination. A small group received DHEA alone. The utilization of adjuvants was decided between the attending clinician and the patient depending on various factors including cost. RESULTS Despite patients being significantly older with lower ovarian reserve, live birth rates were significantly greater with GH alone (18.6%) and with GH-DHEA (13.0%) in comparison to those with no adjuvant (p < 0.003). No significant difference was observed between the GH groups (p = 0.181). Overall, patient age, quality of the transferred embryo, and GH treatment were the only significant independent predictors of live birth chance. Following adjustment for patient age, antral follicle count, and quality of transferred embryo, GH alone and GH-DHEA led to a 7.1-fold and 5.6-fold increase in live birth chance, respectively (p < 0.000). CONCLUSION These data indicated that GH adjuvant may support more live births, particularly in younger women, and importantly, the positive effects of GH treatment were still observed even if DHEA was also used in combination. However, supplementation with DHEA did not indicate any potentiating benefit or modify the effects of GH treatment. Due to the retrospective design, and the risk of a selection bias, caution is advised in the interpretation of the data.
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Affiliation(s)
- Kevin N. Keane
- School of Pharmacy and Biomedical Science, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
- PIVET Medical Centre, Perth, WA, Australia
| | | | | | | | | | - Satvinder S. Dhaliwal
- Faculty of Health Sciences, School of Public Health, Curtin University, Perth, WA, Australia
| | - John L. Yovich
- School of Pharmacy and Biomedical Science, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
- PIVET Medical Centre, Perth, WA, Australia
- *Correspondence: John L. Yovich,
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Pinelli S, Artini PG, Basile S, Obino MER, Sergiampietri C, Giannarelli D, Simi G, Cela V. Estrogen treatment in infertile women with premature ovarian insufficiency in transitional phase: a retrospective analysis. J Assist Reprod Genet 2017; 35:475-482. [PMID: 29204869 DOI: 10.1007/s10815-017-1096-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 11/24/2017] [Indexed: 11/29/2022] Open
Abstract
PURPOSE During the transitional phase of premature ovarian insufficiency (POI), sporadic resumption of ovulation is possible because of fluctuation of hormonal levels but the chance of spontaneous pregnancy is low, and the main perspective of childbearing in these women is egg donation or adoption. The purpose of the study was to verify whether treatment with estrogens in POI patients in transitional phase could reduce FSH levels and to evaluate if this pre-treatment could improve reproductive outcomes of in vitro fertilization (IVF). METHODS Study patients (26) were administered with valerate estradiol 2 mg daily adding dihydrogesterone 10 mg daily during luteal phase for 3 months before IVF. Control group (26 patients) did not receive any pre-treatment. Ovarian stimulation was conducted in both groups with the same short GnRH-antagonist protocol. Clinical and laboratory data of patients were retrospectively analyzed. RESULTS In the study group, 4/26 POI patients became spontaneously pregnant during pre-treatment. In the remaining patients, the mean level of FSH after the pre-treatment was significantly reduced compared with baseline. Levels of circulating estradiol on the day of hCG administration were significantly higher in the study group. The total number of MII oocytes retrieved and fertilized oocytes was significantly higher in the study group, as well as the number of embryos transferred for pickup and clinical pregnancy rate. CONCLUSIONS Treatment with estrogens in infertile POI patients in transitional phase reduces circulating FSH levels, hence causing potential spontaneous conception. Moreover, in these patients, estrogen pre-treatment seems to improve IVF outcomes in a GnRH-antagonist short protocol compared to no pre-treatment.
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Affiliation(s)
- Sara Pinelli
- Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology Oncology, University of Pisa, via Roma 67, 56126, Pisa, Italy.
| | - Paolo Giovanni Artini
- Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology Oncology, University of Pisa, via Roma 67, 56126, Pisa, Italy
| | - Stefano Basile
- Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology Oncology, University of Pisa, via Roma 67, 56126, Pisa, Italy
| | - Maria Elena Rosa Obino
- Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology Oncology, University of Pisa, via Roma 67, 56126, Pisa, Italy
| | - Claudia Sergiampietri
- Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology Oncology, University of Pisa, via Roma 67, 56126, Pisa, Italy
| | - Diana Giannarelli
- Biostatistics Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - Giovanna Simi
- Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology Oncology, University of Pisa, via Roma 67, 56126, Pisa, Italy
| | - Vito Cela
- Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology Oncology, University of Pisa, via Roma 67, 56126, Pisa, Italy
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Keane KN, Yovich JL, Hamidi A, Hinchliffe PM, Dhaliwal SS. Single-centre retrospective analysis of growth hormone supplementation in IVF patients classified as poor-prognosis. BMJ Open 2017; 7:e018107. [PMID: 28993395 PMCID: PMC5640074 DOI: 10.1136/bmjopen-2017-018107] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Patients undergoing in vitro fertilisation (IVF) receive various adjuvant therapies in order to enhance success rates, but the true benefit is actively debated. Growth hormone (GH) supplementation was assessed in poor-prognosis women undergoing fresh IVF transfer cycles. METHODS Data were retrospectively analysed from 400 IVF cycles, where 161 women received GH and 239 did not. RESULTS Clinical pregnancy, live birth rates and corresponding ORs and CIs were significantly greater with GH, despite patients being significantly older with lower ovarian reserve. Patient's age, quality of transferred embryo and GH were the only significant independent predictors of clinical pregnancy (OR: 0.90, 5.00 and 2.49, p<0.002, respectively) and live birth chance (OR: 0.91, 3.90 and 4.75, p<0.014, respectively). GH increased clinical pregnancy chance by 3.42-fold (95% CI 1.82 to 6.44, p<0.0005) and live birth chance by 6.16-fold (95% CI 2.83 to 13.39, p<0.0005) after adjustment for maternal age, antral follicle count and transferred embryo quality. CONCLUSION These data provided further evidence to indicate that GH may support more live births, particularly in younger women. It also appears that embryos generated under GH have a better implantation potential, but whether the biological mechanism is embryo-mediated or endometrium-mediated is unclear.
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Affiliation(s)
- Kevin N Keane
- School of Biomedical Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- PIVET Medical Centre, Perth, Western Australia, Australia
| | - John L Yovich
- School of Biomedical Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- PIVET Medical Centre, Perth, Western Australia, Australia
| | - Anahita Hamidi
- School of Biomedical Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | | | - Satvinder S Dhaliwal
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
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Yovich JL, Alsbjerg B, Conceicao JL, Hinchliffe PM, Keane KN. PIVET rFSH dosing algorithms for individualized controlled ovarian stimulation enables optimized pregnancy productivity rates and avoidance of ovarian hyperstimulation syndrome. DRUG DESIGN DEVELOPMENT AND THERAPY 2016; 10:2561-73. [PMID: 27563236 PMCID: PMC4986677 DOI: 10.2147/dddt.s104104] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The first PIVET algorithm for individualized recombinant follicle stimulating hormone (rFSH) dosing in in vitro fertilization, reported in 2012, was based on age and antral follicle count grading with adjustments for anti-Müllerian hormone level, body mass index, day-2 FSH, and smoking history. In 2007, it was enabled by the introduction of a metered rFSH pen allowing small dosage increments of ~8.3 IU per click. In 2011, a second rFSH pen was introduced allowing more precise dosages of 12.5 IU per click, and both pens with their individual algorithms have been applied continuously at our clinic. The objective of this observational study was to validate the PIVET algorithms pertaining to the two rFSH pens with the aim of collecting ≤15 oocytes and minimizing the risk of ovarian hyperstimulation syndrome. The data set included 2,822 in vitro fertilization stimulations over a 6-year period until April 2014 applying either of the two individualized dosing algorithms and corresponding pens. The main outcome measures were mean oocytes retrieved and resultant embryos designated for transfer or cryopreservation permitted calculation of oocyte and embryo utilization rates. Ensuing pregnancies were tracked until live births, and live birth productivity rates embracing fresh and frozen transfers were calculated. Overall, the results showed that mean oocyte numbers were 10.0 for all women <40 years with 24% requiring rFSH dosages <150 IU. Applying both specific algorithms in our clinic meant that the starting dose was not altered for 79.1% of patients and for 30.1% of those receiving the very lowest rFSH dosages (≤75 IU). Only 0.3% patients were diagnosed with severe ovarian hyperstimulation syndrome, all deemed avoidable due to definable breaches from the protocols. The live birth productivity rates exceeded 50% for women <35 years and was 33.2% for the group aged 35–39 years. Routine use of both algorithms led to only 11.6% of women generating >15 oocytes, significantly lower than recently published data applying conventional dosages (38.2%; P<0.0001). When comparing both specific algorithms to each other, the outcomes were mainly comparable for pregnancy, live birth, and miscarriage rate. However, there were significant differences in relation to number of oocytes retrieved, but the mean for both the algorithms remained well below 15 oocytes. Consequently, application of both these algorithms in our in vitro fertilization clinic allows the use of both the rFSH products, with very similar results, and they can be considered validated on the basis of effectiveness and safety, clearly avoiding ovarian hyperstimulation syndrome.
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Affiliation(s)
- John L Yovich
- PIVET Medical Centre, Perth; School of Biomedical Science, Curtin Health Innovation Research Institute Bioscience, Curtin University, Perth, WA, Australia
| | - Birgit Alsbjerg
- The Fertility Clinic, Skive Regional Hospital, Skive; Faculty of Health, Aarhus University, Aarhus, Denmark
| | | | | | - Kevin N Keane
- PIVET Medical Centre, Perth; School of Biomedical Science, Curtin Health Innovation Research Institute Bioscience, Curtin University, Perth, WA, Australia
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Weissman A, Ravhon A, Steinfeld Z, Nahum H, Golan A, Levran D. Controlled ovarian stimulation using a long gonadotropin-releasing hormone antagonist protocol: a proof of concept and feasibility study. Gynecol Obstet Invest 2013; 76:113-8. [PMID: 23920048 DOI: 10.1159/000351570] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 04/23/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS To evaluate the feasibility of a long protocol of controlled ovarian stimulation prior to in vitro fertilization (IVF) and embryo transfer with a gonadotropin-releasing hormone (GnRH) antagonist used for pituitary and ovarian suppression. METHODS Thirty patients undergoing IVF/intracytoplasmic sperm injection were randomized into two groups. The control group (n = 16) received a standard flexible GnRH antagonist protocol. Ovarian stimulation consisted of 225 IU/day of recombinant follicle-stimulating hormone for 5 days, followed by 225 IU/day of human menopausal gonadotropin until human chorionic gonadotropin (hCG) administration. The study group (n = 14) received 0.25 mg of GnRH antagonist daily for 7 days, thereafter, upon confirmation of pituitary and ovarian suppression, ovarian stimulation was commenced with the same protocol as used in the control group. Hormone and follicle dynamics, as well as laboratory characteristics and cycle outcome, were compared for both groups. RESULTS Both groups were comparable in baseline characteristics. Pituitary and ovarian suppression were effectively achieved in 12/14 patients in the study group. The duration of ovarian stimulation and gonadotropin consumption were similar in both groups, as was also the number and size of follicles on hCG day. CONCLUSION The results of our study confirm the feasibility of a long GnRH antagonist protocol. This regimen could become another option to optimize GnRH antagonist protocols, and should thus be further explored.
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Affiliation(s)
- Ariel Weissman
- IVF Unit, Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Targeted gonadotrophin stimulation using the PIVET algorithm markedly reduces the risk of OHSS. Reprod Biomed Online 2012; 24:281-92. [DOI: 10.1016/j.rbmo.2011.11.014] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Revised: 11/07/2011] [Accepted: 11/16/2011] [Indexed: 11/19/2022]
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Kim CH, You RM, Kang HJ, Ahn JW, Jeon I, Lee JW, Kim SH, Chae HD, Kang BM. GnRH antagonist multiple dose protocol with oral contraceptive pill pretreatment in poor responders undergoing IVF/ICSI. Clin Exp Reprod Med 2011; 38:228-33. [PMID: 22384447 PMCID: PMC3283075 DOI: 10.5653/cerm.2011.38.4.228] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2011] [Revised: 12/09/2011] [Accepted: 12/12/2011] [Indexed: 11/21/2022] Open
Abstract
Objective To investigate the effectiveness of GnRH antagonist multiple-dose protocol (MDP) with oral contraceptive pill (OCP) pretreatment in poor responders undergoing IVF/ICSI, compared with GnRH antagonist MDP without OCP pretreatment and GnRH agonist low-dose long protocol (LP). Methods A total of 120 poor responders were randomized into three groups according to controlled ovarian stimulation (COS) options; GnRH antagonist MDP after OCP pretreatment (group 1), GnRH antagonist MDP without OCP pretreatment (group 2) or GnRH agonist luteal low-dose LP without OCP pretreatment (group 3). Patients allocated in group 1 were pretreated with OCP for 21days in the cycle preceding COS, and ovarian stimulation using recombinant human FSH (rhFSH) was started 5 days after discontinuation of OCP. Results There were no differences in patients' characteristics among three groups. Total dose and days of rhFSH used for COS were significantly higher in group 3 than in group 1 or 2. The numbers of mature oocytes, fertilized oocytes and grade I, II embryos were significantly lower in group 2 than in group 1 or 3. There were no significant differences in the clinical pregnancy rate and implantation rate among three groups. Conclusion GnRH antagonist MDP with OCP pretreatment is at least as effective as GnRH agonist low-dose LP in poor responders and can benefit the poor responders by reducing the amount and duration of FSH required for follicular maturation.
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Affiliation(s)
- Chung-Hoon Kim
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Wei Z, Cheng X, Li H, Cao Y, Cong L, Zhou P, Li J. Effects of prolonging administration gonadotropin on unexpectedly poor ovarian responders undergoing in vitro fertilization. Reprod Biol Endocrinol 2010; 8:26. [PMID: 20236519 PMCID: PMC2845138 DOI: 10.1186/1477-7827-8-26] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Accepted: 03/17/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There are still some patients who show poor response to ovarian stimulation prior to evidence of normal ovarian reserve in vitro fertilization. However, there are few studies about how to treat the unexpectedly ovarian poor responder in vitro fertilization. The main aim of this study evaluate the effect of prolonging administration follicle-stimulating hormone in woman with the unexpectedly ovarian poor responder in vitro fertilization on implantation rate, clinical pregnancy rate and live birth rate. METHODS 922 patients subjected to IVF were divided into two groups according to the predicted criterion of ovarian poor response. 116 patients predicted poor response received the short protocol (group C). The others received the long protocol, among the latter, there were 149 patients undergoing unexpectedly ovarian poor response (group B) and 657 patients exhibited normal ovarian response (group A). The doses of gonadotropin, duration of administration, implantation rate, clinical pregnancy rate and live birth rate were recorded among three groups. RESULTS The implantation rate of embryo, clinic pregnancy rate and delivery rate are similar between the group A and group B, while there are significant differences between the doses of gonadotropins (35.1 +/- 8.9 ampules vs.53.0 +/- 15.9 ampules) and the duration of administration (15.3 +/- 3.6D vs. 9.8 +/- 2.6D) of these two groups. There are no significant differences about clinical pregnancy rate and live birth rate between group B and group C. CONCLUSION Prolonging administration gonadotropin on the unexpectedly poor ovarian responders does not lower live birth rate in vitro fertilization.
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Affiliation(s)
- Zhaolian Wei
- Reproductive Medicine Center, The First Affiliated Hospital, Anhui Medical University, Hefei, 230022, PR China
| | - Xianxia Cheng
- Reproductive Medicine Center, The First Affiliated Hospital, Anhui Medical University, Hefei, 230022, PR China
| | - Huirong Li
- Reproductive Medicine Center, The First Affiliated Hospital, Anhui Medical University, Hefei, 230022, PR China
| | - Yunxia Cao
- Reproductive Medicine Center, The First Affiliated Hospital, Anhui Medical University, Hefei, 230022, PR China
| | - Lin Cong
- Reproductive Medicine Center, The First Affiliated Hospital, Anhui Medical University, Hefei, 230022, PR China
| | - Ping Zhou
- Reproductive Medicine Center, The First Affiliated Hospital, Anhui Medical University, Hefei, 230022, PR China
| | - Jun Li
- Pharmacological college, Anhui Medical University, Hefei, 230022, PR China
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Keskintepe L, Agca Y, Sher G, Keskintepe M, Maassarani G. High survival rate of metaphase II human oocytes after first polar body biopsy and vitrification: determining the effect of previtrification conditions. Fertil Steril 2009; 92:1706-15. [DOI: 10.1016/j.fertnstert.2008.08.114] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2008] [Revised: 08/16/2008] [Accepted: 08/21/2008] [Indexed: 11/28/2022]
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