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)
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 Me...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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World Scientific Publishing
2021-09-01
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| Series: | Fertility & Reproduction |
| Subjects: | |
| Online Access: | http://www.worldscientific.com/doi/epdf/10.1142/S2661318221500146 |
| _version_ | 1818728187272626176 |
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| author | Akshara Shyamsunder Tristan Hardy Anusch Yazdani Alex Polyakov Robert Norman Roger Hart Franca Agresta Luk Rombauts Clare Boothroyd Michael Chapman Prudence Sweeten Eleanor Somerville Rachel Jose Handan Wand William L. Ledger |
| author_facet | Akshara Shyamsunder Tristan Hardy Anusch Yazdani Alex Polyakov Robert Norman Roger Hart Franca Agresta Luk Rombauts Clare Boothroyd Michael Chapman Prudence Sweeten Eleanor Somerville Rachel Jose Handan Wand William L. Ledger |
| author_sort | Akshara Shyamsunder |
| collection | DOAJ |
| description | 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 (R = 0.3359, R2 = 0.1129 and R = 0.3741, R2 = 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 (p = 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. |
| first_indexed | 2024-12-17T22:26:00Z |
| format | Article |
| id | doaj.art-252b848c234447dd975f7162d9282545 |
| institution | Directory Open Access Journal |
| issn | 2661-3182 2661-3174 |
| language | English |
| last_indexed | 2024-12-17T22:26:00Z |
| publishDate | 2021-09-01 |
| publisher | World Scientific Publishing |
| record_format | Article |
| series | Fertility & Reproduction |
| spelling | doaj.art-252b848c234447dd975f7162d92825452022-12-21T21:30:20ZengWorld Scientific PublishingFertility & Reproduction2661-31822661-31742021-09-013310811410.1142/S266131822150014610.1142/S2661318221500146Higher 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)Akshara Shyamsunder0Tristan Hardy1Anusch Yazdani2Alex Polyakov3Robert Norman4Roger Hart5Franca Agresta6Luk Rombauts7Clare Boothroyd8Michael Chapman9Prudence Sweeten10Eleanor Somerville11Rachel Jose12Handan Wand13William L. Ledger14Fertility and Research Centre, Royal Hospital for Women, Sydney, AustraliaSchool of Women’s & Children’s Health, University of New South Wales, Sydney, AustraliaQueensland Fertility Group, Brisbane, AustraliaMelbourne IVF, Melbourne, AustraliaFertility SA, Adelaide, AustraliaFertility Specialists of Western Australia, Perth, AustraliaMelbourne IVF, Melbourne, AustraliaMonash IVF, Melbourne, AustraliaIVF MED, Brisbane, AustraliaSchool of Women’s & Children’s Health, University of New South Wales, Sydney, AustraliaSchool of Women’s & Children’s Health, University of New South Wales, Sydney, AustraliaSchool of Women’s & Children’s Health, University of New South Wales, Sydney, AustraliaSchool of Women’s & Children’s Health, University of New South Wales, Sydney, AustraliaSchool of Women’s & Children’s Health, University of New South Wales, Sydney, AustraliaSchool of Women’s & Children’s Health, University of New South Wales, Sydney, AustraliaResearch 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 (R = 0.3359, R2 = 0.1129 and R = 0.3741, R2 = 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 (p = 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.http://www.worldscientific.com/doi/epdf/10.1142/S2661318221500146aneuploidyarteuploidgonadotrophinspgs |
| spellingShingle | Akshara Shyamsunder Tristan Hardy Anusch Yazdani Alex Polyakov Robert Norman Roger Hart Franca Agresta Luk Rombauts Clare Boothroyd Michael Chapman Prudence Sweeten Eleanor Somerville Rachel Jose Handan Wand William L. Ledger 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 aneuploidy art euploid gonadotrophins pgs |
| title | 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) |
| title_full | 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) |
| title_fullStr | 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) |
| title_full_unstemmed | 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) |
| title_short | 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) |
| title_sort | 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 |
| topic | aneuploidy art euploid gonadotrophins pgs |
| url | http://www.worldscientific.com/doi/epdf/10.1142/S2661318221500146 |
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