MILD ovarian stimulation with GnRH-antagonist vs. long protocol with low dose FSH for non-PCO high responders undergoing IVF: a prospective, randomized study including thawing cycles

Casano, Simona; Guidetti, Daniela; Patriarca, A; Pittatore, Giulia; Gennarelli, Gianluca; Revelli, Alberto

doi:10.1007/s10815-012-9863-2

Cited by 27 publications

(33 citation statements)

References 24 publications

(43 reference statements)

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“…Interestingly enough, a recent post hoc analysis of the Engage trial confirmed that after CFα stimulation the ongoing PR/ET of patients in which 6-9 oocytes were retrieved was comparable to that of patients that obtained 10-13 oocytes (26). Indeed the results presented herein are similar to those reported in a study previously published by our group, in which a low dose of daily rFSH (150 IU) was administered from day 4 to expected normal responder, non-PCO women: in that trial, in fact, a mean of 9.9 MII oocytes were retrieved and an ongoing PR/ET at 10 weeks of 35.9 % was obtained (27).…”

Section: Discussionsupporting

confidence: 90%

Efficacy and safety of late-start Corifollitropin-alfa administration for controlled ovarian hyperstimulation in IVF: a cohort, case–control study

Revelli

Pittatore

Casano

et al. 2015

J Assist Reprod Genet

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Objective To investigate efficacy and safety of a controlled ovarian stimulation (COS) protocol in which a single dose of Corifollitropin-alfa (CFα) was administered on day 4 of a GnRH-antagonist cycle. Design Cohort case-control study. Setting University Hospital. Patients One hundred twenty-two normally cycling women expected to be normal responders to COS. Interventions In 61 patients, CFα (100-150 μg) was injected subcutaneously on day 4 of a spontaneous menstrual cycle; a GnRH-antagonist was added from day 8 (fixed protocol; 0.25 mg/day). If needed to complete follicular maturation, recombinant FSH (rFSH) daily injections (150/200 IU/day) were given from day 11. A control group of 61 matched women was stimulated with daily subcutaneous injections of rFSH (100-150 U/day) from day 4 of the cycle, and received GnRH-antagonist (0.25 mg/day) from day 8. IVF or ICSI was performed according to the sperm characteristics, and 1-2 embryos were transferred in utero under US guidance on day 2.Main outcome measures Number of retrieved cumulusoocyte complexes (COCs), clinical pregnancy rate (PR), implantation rate (IR), ongoing PR at 10 weeks, number of injections/cycle, ovarian hyperstimulation syndrome (OHSS) rate.Results No cycle was cancelled and the mean number of retrieved COCs was comparable in patients and controls. About 60 % of CF-alfa treated women had no need of daily rFSH addition, and the mean number of injections/cycle was significantly lower in the CF-alfa group than in controls (p<0.05). The ongoing PR/transfer was 36.8 % in CF-alfa group and 37.5 % in controls. No patient developed severe OHSS, and the incidence of moderate OHSS was similar in cases and controls. Conclusions CFα may be started on day 4 of the cycle obtaining results comparable to those of a COS using day 4-start daily rFSH, with significantly less injections and a similar risk of OHSS.

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Section: Discussionsupporting

confidence: 90%

Efficacy and safety of late-start Corifollitropin-alfa administration for controlled ovarian hyperstimulation in IVF: a cohort, case–control study

Revelli

Pittatore

Casano

et al. 2015

J Assist Reprod Genet

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“…The risk for OHSS may be reduced in women with high AMH levels who receive lower doses of gonadotropins for shorter periods (a mild stimulation protocol) (Anckaert et al, 2012;Nelson et al, 2007). Thus, the choice of an antagonist-controlled protocol (with mild stimulation doses) may minimize the frequency of cycle cancellations caused by OHSS in women with high AMH levels (Arce et al, 2014;Casano et al, 2012;Fauser et al, 2010;Hamdine et al, 2014;Nelson et al, 2007). Additionally, a recent analysis of two prospective, randomized trials comprising over 1400 assisted reproduction technique cycles indicated that selection of gonadotrophin, i.e.…”

Section: Amh: the Evidence As A Predictive Methodsmentioning

confidence: 99%

Assessing ovarian response: antral follicle count versus anti-Müllerian hormone

Fleming¹,

Seifer

Frattarelli³

et al. 2015

Reproductive BioMedicine Online

219

148

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“…We found the same results in our study. As demonstrated in this study, there is no difference in oocytes retrieval between these two protocols in recent meta analysis (Tehraninejad et al, 2010;Bodri et al, 2011;Pu et al, 2011;Casano et al, 2012;Pundir et al, 2012) and randomized controlled trials (Loutradis et al, 2004;Xavier et al, 2005;Kurzawa et al, 2008;Tazegul et al, 2008). Differently, some reports showed a less number of oocyte retrieval in the antagonist protocol (Barmat et al, 2005;Arruda et al, 2013;Orvieto & Patrizio, 2013).…”

Section: Discussionmentioning

confidence: 50%

Ovarian stimulation with GnRH analogues

Montenegro¹,

Faller²,

Almeida³

et al. 2014

JBRA Assisted Reproduction

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Objective: Analysis and compare data between two induction protocols (long agonist and flexible antagonist) in patients submitted an assisted reproduction technique in Porto Alegre. Methods: Cross-sectional study comparing the intermediate results with the use of two different ovarian stimulation protocols with gonadotropin-releasing hormone agonist versus antagonist to assisted reproductive techniques. The statistical analysis of the retrieved data (age, body mass index, number of oocytes recovered, number of fertilized oocytes, number of oocytes cleaved, total dose of FSH used and ovarian hyperstimulation syndrome) was performed by Student's t-test for parametric data and analysis of covariance for the dependent variables. Results: A total of 50 patients, 25 in each group, met the criteria for inclusion in the study between January and March in the year 2010. There was statistically significant difference only in the middle ages between the groups (P = 0.031). There was no statistical difference for the remaining data analyzed (body mass index, number of oocytes recovered, number of fertilized oocytes, number of oocytes cleaved and dose of FSH utilized). There were no cases of ovarian hyperstimulation syndrome. Conclusion: Both protocols are equal in terms of results. The agonist has advantages about scheduling of the procedure, but it takes too long to start the stimulation and have possibility to start medication in a pregnant patient. Added to this, we have the possibility of getting the ovarian hyperstimulation syndrome as complication. In the antagonist group, is clear the ease-of-use of the medication and the fastest start of stimulation.

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MILD ovarian stimulation with GnRH-antagonist vs. long protocol with low dose FSH for non-PCO high responders undergoing IVF: a prospective, randomized study including thawing cycles

Cited by 27 publications

References 24 publications

Efficacy and safety of late-start Corifollitropin-alfa administration for controlled ovarian hyperstimulation in IVF: a cohort, case–control study

Efficacy and safety of late-start Corifollitropin-alfa administration for controlled ovarian hyperstimulation in IVF: a cohort, case–control study

Assessing ovarian response: antral follicle count versus anti-Müllerian hormone

Ovarian stimulation with GnRH analogues

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