Duration of ovarian stimulation is predictive of in-vitro fertilization outcomes

Sarkar, Papri; Ying, Luke Y.; Plosker, Shayne; Mayer, James C.; Ying, Ying; Imudia, Anthony N.

doi:10.23736/s0026-4784.19.04455-1

Cited by 6 publications

(6 citation statements)

References 18 publications

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Section: Discussionmentioning

confidence: 99%

“…A number of authors have found that in the different protocols (long, antagonist or flare stimulation protocol), the duration of ovarian stimulation has no negative effect on the success rate in IVF/ICSI procedure (40). Optimal ovarian response and pregnancy outcome is associated with stimulation duration between 9 -12 days (41). Several authors have sought an answer to the question, whether changing the day for follicular puncture by one day from the optimal one (determined by ultrasound), has a negative effect on the quality of aspirated oocytes, respectively embryos and delivery rate.…”

Section: The Question Arises Does the Day Of Follicular Puncture Depe...mentioning

confidence: 99%

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A new method of Non-Ultrasound Monitoring of Ovarian Stimulation (NUMOS): Mission Possible! - a pilot study

Vladimirov,

Tacheva,

Gatev

et al. 2023

Preprint

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Purpose: This study aims to establish the viability of monitoring an appropriate and safe ovarian stimulation without the use of ultrasound and serum hormone testing. Method: As a primary marker for monitoring of the ovarian response, we used urinary estrone-3-glucuronide (E1-3G) growth rate, which was self-measured by patients daily at home, with a portable analyzer, during the stimulation. For an adequate ovarian response, an average daily rate of increase of E1-3G was estimated to be within 25 - 77%. Ovulation trigger day was determined based on the length of the menstrual cycle. The study included 24 women. Inclusion criteria were age < 41 years and AMH >1 ng/mL. A progestin-primed ovarian stimulation protocol (PPOS) with fixed doses of gonadotropins was used. Results: The average female age was 32,9 years (±4.4), BMI 22,7 kg/m2 (±4,3), AMH 3,7 ng/ml (±2,6), stimulation days 10,6 (±1,1), collected oocytes 12,5 (±8,5), MII oocytes 10,6 (±7,8), fertilization rate 83,6% (±22,5), blastocyst 66,4% (±28,6), good quality blastocysts 31,6% (±16,9). Absence of oocyte aspiration was found in one of the cases. There were no cases of OHSS and ovarian stimulation cancellation. Conclusion: This is the first pilot study to successfully apply a new markers for ovarian stimulation monitoring.

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Section: Discussionmentioning

confidence: 99%

Section: The Question Arises Does the Day Of Follicular Puncture Depe...mentioning

confidence: 99%

A new method of Non-Ultrasound Monitoring of Ovarian Stimulation (NUMOS): Mission Possible! - a pilot study

Vladimirov,

Tacheva,

Gatev

et al. 2023

Preprint

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“…Longer stimulation period lowers the risk of a suboptimal maturation response. The literature regarding the optimal stimulation duration and impact on IVF outcomes has been conflicting ( Chuang et al ., 2010 ; Sarkar et al ., 2019 ; Yang et al ., 2019b ; Stout et al ., 2022 ). In cases of PT with a GnRH agonist, a prolonged stimulation period could supposedly enable a recovery time for the desensitized pituitary.…”

Section: Discussionmentioning

confidence: 99%

Impact of pre-treatment in GnRH-antagonist cycles triggered with GnRH agonist on reproductive outcomes

Zivi,

Eldar-Geva,

Rubinstein

et al. 2023

JBRA

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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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“…In contrast, Chuang et al found that a prolonged duration of gonadotropin stimulation of 13 days or more was an independent negative predictive factor of ART success [5]. Sarka et al recently reported that both prolonged and short stimulation durations were associated with lower live-birth rates, and that optimal outcomes were achieved for stimulation durations between 9 and 12 days [6].…”

Section: Introductionmentioning

confidence: 97%

“…However, as this decision may be influenced by other factors such as the size of the growing follicle cohort and hormonal levels on the day of monitoring, the European Society of Human Reproduction and Embryology (ESHRE) guidelines recommend a case-by-case approach [2]. The results from studies reporting optimal stimulation durations for patients undergoing in vitro fertilization (IVF) cycles are inconsistent [3][4][5][6]. Some authors have reported that women with a short duration of stimulation had the same likelihood of becoming pregnant as those with a longer duration of stimulation [3,4].…”

Section: Introductionmentioning

confidence: 99%

Stimulation Duration in Patients with Early Oocyte Maturation Triggering Criteria Does Not Impact IVF-ICSI Outcomes

Stout

Dabi

Dupont

et al. 2022

JCM

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Results from studies reporting the optimal stimulation duration of IVF-ICSI cycles are inconsistent. The aim of this study was to determine whether, in the presence of early ovulation-triggering criteria, prolonged ovarian stimulation modified the chances of a live birth. This cross-sectional study included 312 women presenting triggering criteria beginning from D8 of ovarian stimulation. Among the 312 women included in the study, 135 were triggered for ovulation before D9 (D ≤ nine group) and 177 after D9 (D > nine group). The issues of fresh +/− frozen embryo transfers were taken into consideration. Cumulative clinical pregnancy and live-birth rates after fresh +/− frozen embryo transfers were similar in both groups (37% versus 46.9%, p = 0.10 and 19.3% versus 28.2%, p = 0.09, respectively). No patient characteristics were found to be predictive of a live birth depending on the day of ovulation trigger. Postponing of ovulation trigger did not impact pregnancy or live-birth rates in early responders. A patient’s clinical characteristics should not influence the decision process of ovulation trigger day in early responders. Further prospective studies should be conducted to support these findings.

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Duration of ovarian stimulation is predictive of in-vitro fertilization outcomes

Cited by 6 publications

References 18 publications

A new method of Non-Ultrasound Monitoring of Ovarian Stimulation (NUMOS): Mission Possible! - a pilot study

A new method of Non-Ultrasound Monitoring of Ovarian Stimulation (NUMOS): Mission Possible! - a pilot study

Impact of pre-treatment in GnRH-antagonist cycles triggered with GnRH agonist on reproductive outcomes

Stimulation Duration in Patients with Early Oocyte Maturation Triggering Criteria Does Not Impact IVF-ICSI Outcomes

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