Annulations en fécondation in vitro : mauvais pronostic, mauvaises répondeuses, ou variabilité de la réponse à la stimulation ? Analyse de 142 annulations

Lamazou, F.; Fuchs, Florent; Grynberg, Michaël; Gallot, V.; Herzog, Erika Herrera; Fanchin, Rénato; Frydman, Nelly; Frydman, René

doi:10.1016/j.jgyn.2011.06.001

Cited by 15 publications

(3 citation statements)

References 46 publications

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“…However, report suggested that modi ed natural cycle is of no bene t with less than 1% live birth rate for genuine poor responders who yielded up to 3 oocytes with conventional COH [28]. The lower ongoing pregnancy rate resulted from mild stimulation was especially due to a high cancellation rate [29]. In our analysis, the whole nancial expenditure per person of repeated minimal ovarian stimulation turns to be similar with GnRH-antagonist protocol.…”

Section: Discussionmentioning

confidence: 52%

Cumulative live birth rate and cost-effectiveness analysis between GnRH-antagonist protocol and multiple minimal ovarian stimulation in poor responder

Liu

2020

Preprint

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Background The overall cumulative live birth rate (CLBR) of poor ovary responders (POR) is extremely low. Minimal ovarian stimulation (MOS) suggested a relative realistic solution in ART for POR. Our study aimed to investigate whether multiple MOS strategy results in higher CLBR compared to GnRH antagonist protocol and the cost-effectiveness analysis in POR. Methods This retrospective study involved 699 patients (1058 cycles) who fulfilled the Bologna criteria in one center performed from 2010–2018. Specifically, 325 women (325 cycles) were treated with one time conventional GnRH antagonist ovarian stimulation (GnRH-antagonist). Another 374 patients (733 cycles) were treated with multiple minimal ovarian stimulations (MOS) including natural cycles. CLBR and cost-effectiveness analysis were performed comparing these two groups of women. Results GnRH- antagonist leads to more oocytes retrieved, more fertilized oocytes and more viable embryos compared to first MOS (p < 0.001) and the cumulative corresponding ones in multiple MOS (p < 0.001). For the first IVF cycle, GnRH- antagonist results in higher CLBR than MOS (12.92% versus 4.54%, Adjusted OR 2.606; 95%CI 1.386, 4.899, p = 0.003). However, GnRH-antagonist induces comparable CLBR with multiple MOS (12.92% versus 7.92%, Adjusted OR 1.702; 95%CI 0.971, 2.982, p = 0.063), but absolutely shorter time to live birth (9 (8, 10.75) months versus 11 (9, 14) months, p = 0.014) and similar financial expenditure compared to repeated MOS (20838 (17953, 23422) ¥ versus 21261.5 (15892.5, 35140.25) ¥, p = 0.13). Conclusion Both MOS and GnRH-antagonist provide low chance of live birth for poor responders. GnRH antagonist protocol is a sound choice for POR with comparable CLBR, shorter time to live birth and similar financial expenditure.

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Section: Discussionmentioning

confidence: 52%

Cumulative live birth rate and cost-effectiveness analysis between GnRH-antagonist protocol and multiple minimal ovarian stimulation in poor responder

Liu

2020

Preprint

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“…Controlled ovarian hyperstimulation (COH) is a key part of assisted reproductive technology and plays a vital role in the success or failure of treatment. Several clinical studies have shown that patients with low AMH levels have a higher cancellation rate of oocytes retrieval cycles because of low ovarian response (6)(7)(8)(9). Some researchers also pointed out that AMH levels are correlated with the number of oocytes retrieved, fertilization rate, number of embryos available and clinical pregnancy (10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Relationship Between Anti-Müllerian Hormone and In Vitro Fertilization-Embryo Transfer in Clinical Pregnancy

et al. 2020

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ObjectivesTo retrospectively analyze the correlation between anti-Müllerian hormone (AMH) and the number of oocytes obtained by controlled ovarian hyperstimulation (COH) in women of different ages and explore the factors affecting in vitro fertilization and embryo transfer (IVF-ET) in clinical pregnancy of infertile women to provide evidence for infertile women to choose assisted reproduction strategies.MethodsInfertile women who received IVF-ET or intracytoplasmic sperm injection and embryo transfer (ICSI-ET) treatment in the reproductive center of XX hospital between October 2018 and September 2019 were included. Patient data on medical records, age, body mass index (BMI), years of infertility, basic follicle-stimulating hormone (FSH), basic luteinizing hormone (LH), basic estradiol (E2), anti-Müllerian hormone level (AMH), antral follicle count (AFC), gonadotropins (Gn) medication days, Gn dosage, endometrial thickness on transplantation day, the number of retrieved oocytes, the number of mature oocytes obtained, the number of embryos transferred, clinical pregnancy status, etc., were collected.ResultsA total of 314 patients were enrolled in this study, with an average age of 31.0 ± 4.5 years. The infertility period ranged from 0–21 years. The AMH level showed a downward trend with increasing age. Overall, the AMH level of women of all ages was positively correlated with the number of retrieved oocytes (r = 0.335, p < 0.001). The AMH level of women between 22 and 28 years old was positively correlated with the number of retrieved oocytes (r = 0.164, p < 0.061) but it was not statistically significant. Similarly, the AMH level of women aged 29–35 and 36–43 was positively correlated with the number of retrieved oocytes (r = 0.356, p < 0.001; r = 0.461, p < 0.001). The average age of the pregnant group (30.6 ± 4.4 years) was lower than that of the non-pregnant group (32.2 ± 4.6 years) (p < 0.001). The number of oocytes obtained (9.8 ± 4.5) and the number of embryos transferred (1.9 ± 0.4) in the pregnant group was significantly higher than that in the non-pregnant group (9.2 ± 4.5; 1.7 ± 0.5); the difference was statistically significant. The multivariate logistic regression model showed that age (OR = 0.574 95% CI: 0.350–0.940), AMH (OR = 1.430 95% CI: 1.130–1.820) and the number of oocytes obtained (OR = 1.360 95% CI: 1.030–1.790) were factors affecting clinical pregnancy.ConclusionWe found that the level of AMH in infertile women decreased with age and the number of oocytes obtained in infertile women was positively correlated with AMH. Moreover, the number of oocytes and embryo transferred in the pregnant group was significantly higher than those in the non-pregnant group. Furthermore, age, AMH and the number of oocytes affected the clinical pregnancy.

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“…16 Even though increasing the gonadotropin dose may increase follicular recruitment, this may not lead to higher pregnancy rates. 9,17 Lamazou et al 18 defined poor prognostic criteria as follows: patient age > 38 years, antral follicle count < 10 on cycle day 3, and day 3 serum FSH levels > 10 IU/L. Accordingly, we decided to compare the pregnancy outcomes of women aged ≤ 38 years who develop fewer than five follicles following ovarian stimulation with those in women aged > 38 years who also developed fewer than five follicles.…”

Section: Introductionmentioning

confidence: 99%

Pregnancy Rates in Older Poor Responders Who Achieve Embryo Transfer in Long Down-Regulated ART Cycles Are Comparable to Those in Younger Poor Responders

Yoldemir

Fraser

2012

Journal of Obstetrics and Gynaecology Canada

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Annulations en fécondation in vitro : mauvais pronostic, mauvaises répondeuses, ou variabilité de la réponse à la stimulation ? Analyse de 142 annulations

Cited by 15 publications

References 46 publications

Cumulative live birth rate and cost-effectiveness analysis between GnRH-antagonist protocol and multiple minimal ovarian stimulation in poor responder

Cumulative live birth rate and cost-effectiveness analysis between GnRH-antagonist protocol and multiple minimal ovarian stimulation in poor responder

Relationship Between Anti-Müllerian Hormone and In Vitro Fertilization-Embryo Transfer in Clinical Pregnancy

Pregnancy Rates in Older Poor Responders Who Achieve Embryo Transfer in Long Down-Regulated ART Cycles Are Comparable to Those in Younger Poor Responders

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