1
|
Shyamsunder A, Hardy T, Yazdani A, Polyakov A, Norman R, Hart R, Agresta F, Rombauts L, Boothroyd C, Chapman M, Sweeten P, Somerville E, Jose R, Wand H, Ledger WL. Higher Doses of FSH Used for Superovulation Do Not Adversely Affect Embryonic Ploidy: A Randomized Controlled Trial (STimulation Resulting in Embryonic Aneuploidy using Menopur (STREAM) Trial). FERTILITY & REPRODUCTION 2021. [DOI: 10.1142/s2661318221500146] [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
Research Question: Does the dose of gonadotropin used for superovulation in IVF affect the proportion of euploid blastocysts obtained after fertilization? Study Design: Multicentre randomized controlled trial recruiting 57 women who were treated with ovarian stimulation using either 150 or 300 IU Menopur per day. Both groups received GnRH antagonist from day 5 of ovarian stimulation and final oocyte maturation was induced using a leuprolide GnRH (gonadotropin releasing hormone) agonist trigger when three or more follicles reached 17 mm diameter. Oocyte collection was scheduled 36–38 hours post trigger. In vitro fertilization (IVF) or Intracytoplasmic Sperm Injection (ICSI) were performed according to individual unit protocol and embryos were cultured to blastocyst stage. A trophectoderm biopsy was performed on day 5 of embryo culture and used for preimplantation genetic testing for aneuploidy. Euploid embryos were transferred in subsequent frozen embryo transfer cycles with appropriate endometrial preparation. Results: The number of oocytes obtained from women randomized to 150 IU Menopur was between 3 and 17 (mean = 9), whereas the number of oocytes obtained from women randomized to 300 IU Menopur was between 3 and 24 (mean = 11). There was a positive linear relationship between serum AMH concentration and oocyte yield in both the 150 and 300 IU Menopur groups ([Formula: see text] = 0.3359, [Formula: see text] = 0.1129 and [Formula: see text] = 0.3741, [Formula: see text] = 0.1399). The percentage of euploid to aneuploid embryos in the 150 IU Menopur group was 63% and in the 300 IU Menopur group, the proportion was 75%, which was not significantly different ([Formula: see text] = 0.17). Conclusion: The higher dose ovarian stimulation protocol did not significantly increase the number of oocytes retrieved, nor did the higher dose protocol reduce the proportion of euploid embryos created. This study does not support the hypothesis that use of higher doses of gonadotropin for ovarian stimulation results in a reduction in the proportion of euploid embryos obtained after IVF.
Collapse
Affiliation(s)
| | - Tristan Hardy
- School of Women’s & Children’s Health, University of New South Wales, Sydney, Australia
| | | | | | | | - Roger Hart
- Fertility Specialists of Western Australia, Perth, Australia
| | | | | | | | - Michael Chapman
- School of Women’s & Children’s Health, University of New South Wales, Sydney, Australia
- IVF Australia, Sydney, Australia
| | - Prudence Sweeten
- School of Women’s & Children’s Health, University of New South Wales, Sydney, Australia
- IVF Australia, Sydney, Australia
| | - Eleanor Somerville
- School of Women’s & Children’s Health, University of New South Wales, Sydney, Australia
| | - Rachel Jose
- School of Women’s & Children’s Health, University of New South Wales, Sydney, Australia
| | - Handan Wand
- School of Women’s & Children’s Health, University of New South Wales, Sydney, Australia
| | - William L. Ledger
- School of Women’s & Children’s Health, University of New South Wales, Sydney, Australia
- IVF Australia, Sydney, Australia
- Fertility and Research Centre, Royal Hospital for Women, Sydney, Australia
| |
Collapse
|
2
|
Fauser BCJM, Macklon NS. May the colleague who truly has no conflict of interest now please stand up! Reprod Biomed Online 2019; 39:541-544. [PMID: 31540846 DOI: 10.1016/j.rbmo.2019.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - N S Macklon
- Faculty of Medicine, University of Southampton. UK
| |
Collapse
|
4
|
Yovich JL, Casper R, Chapman M, Tesarik J, Anderson RA. Regulating ART: time for a re-think in the light of increasing efficacy, safety and efficiency. Reprod Biomed Online 2019; 38:483-486. [PMID: 30704951 DOI: 10.1016/j.rbmo.2019.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- John L Yovich
- PIVET Medical Centre, Perth, Australia; Curtin University, Perth, Australia.
| | - Robert Casper
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada
| | - Michael Chapman
- Royal Hospital for Women, University of New South Wales, NSW Australia
| | | | - Richard A Anderson
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| |
Collapse
|