Impact of duration and dose of gonadotrophins on IVF outcomes

Abstract

In order to examine whether the duration of the follicular phase and changes in daily gonadotrophin dosages impact IVF outcome, a retrospective analysis of women who underwent oocyte retrieval and fresh embryo transfer was performed. Among the parameters assessed were the number of days of gonadotrophin stimulation, changes in the daily dosage of gonadotrophins, total ampoules of gonadotrophins, embryo implantation rates, clinical pregnancy rates and ongoing pregnancy rates. The number of days of gonadotrophin stimulation, as determined by standard follicular size criteria did not appear to influence IVF outcomes. There was no significant difference in pregnancy rates between women who were stimulated for <9 days, 10-11 days or >12 days. When grouped by amount of starting daily dose of gonadotrophins there was a significant inverse relationship between gonadotrophin requirements and pregnancy rates (P=0.02). The data suggest that the success of an IVF cycle depends on the ovaries' ability to develop follicles of the appropriate size, not the speed at which the ovaries perform this function.

Prolonged gonadotropin stimulation is associated with decreased ART success

“…Martin et al recently reported no effect of the length of gonadotropin stimulation on clinical pregnancy following ART in a univariate analysis of 555 cycles [12]. Several potential differences between our studies may account for [10,14]; thus, lack of correspondence of body composition between the two studies may explain the lack of agreement.…”

“…Using a univariate analysis, a recent study reported that the length of stimulation did not affect clinical pregnancy outcomes following ART [12]. A number of parameters may influence both the duration of gonadotropin stimulation and the likelihood of success, and, thus, constitute potential confounders.…”

The effects of prognostic factors on pregnancy success among women 39 years or older having intracytoplasmic sperm injection

“…Martin ve ark. 555 adet siklusla yaptıkları çalışmada gonadotropin stimülasyon süresinin ve dozunun gebelik sonuçlarını etkilemediğini rapor etmişlerdir (25) . Bizim çalışmamızda, toplam kullanılan gonodotropin dozunun ve stimülasyon süresinin gebelik başarısını etkilemediği ancak yaş grupları arasında Grup 1'de Grup 3'e göre stimülasyon süresinin istatistiksel olarak anlamlı uzun olduğu gözlenmiştir.…”

Optimal control of dosage decisions in controlled ovarian hyperstimulation

“…When the clinicians identify a patient's responsiveness class before the COH cycle, typical predictive factors involve her medical characteristics such as age, BMI, previous IVF-ET experience(s), number of antral follicles (follicles with diameter 2-5 mm), and ovary diameters, the last two of which are related to the diagnosis of PCOS (Martin et al 2006;Chang et al 1998;Ku et al 2006). In this study, all patients are with PCOS or PCOS potential, Fig.…”