Outcomes of High Initial Daily Doses of Gonadotropin in Patients With Poor Ovarian Reserve
Objective: To evaluate the in vitro fertilization and intracytoplasmic sperm injection outcomes after high initial doses of follicle-stimulating hormone (FSH) in patients with poor ovarian reserve. Materials and Methods: For in vitro fertilization/intracytoplasmic sperm injection patients younger th...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2010-12-01
|
| Series: | Taiwanese Journal of Obstetrics & Gynecology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1028455910600964 |
| _version_ | 1818252325732483072 |
|---|---|
| author | Li-Ling Chou Yuh-Ming Hwu Ming-Huei Lin Shyr-Yeu Lin Robert Kuo-Kuang Lee |
| author_facet | Li-Ling Chou Yuh-Ming Hwu Ming-Huei Lin Shyr-Yeu Lin Robert Kuo-Kuang Lee |
| author_sort | Li-Ling Chou |
| collection | DOAJ |
| description | Objective: To evaluate the in vitro fertilization and intracytoplasmic sperm injection outcomes after high initial doses of follicle-stimulating hormone (FSH) in patients with poor ovarian reserve.
Materials and Methods: For in vitro fertilization/intracytoplasmic sperm injection patients younger than 40 years of age, 345 cycles were examined from April 2003 to April 2007. As a control, 218 cycles received gonadotropin-releasing hormone agonist and regular initial doses of FSH from day 3 of the treated cycle. The remaining 127 cycles were treated with high initial doses of FSH with an antagonist or low doses of gonadotropin-releasing hormone because of poor ovarian reserve.
Results: When higher initial doses of FSH were used, lower estradiol levels on the day of human chorionic gonadotropin injection and less mature oocytes were retrieved from the group with poor ovarian reserve. Clinical pregnancy rates per embryo transfer were similar (45.7% vs. 48.2%, p = 0.686). There was a trend of lower ongoing pregnancy rate per cycle (28.3% vs. 38.5%, p = 0.05) in the study compared with the control group. In the subgroups with high doses of FSH, neither protocol was superior in terms of clinical (45.5% vs. 46.2%, p=0.952) or ongoing pregnancy rates per embryo transfer (37.9% vs. 42.3%, p=0.695).
Conclusion: There was no significant difference in clinical pregnancy rate of the two groups when good embryos were obtained. The group with poor ovarian reserve had lower ongoing pregnancy rates per cycle. For patients with expected poor ovarian response, treatment with high doses of FSH initially is an option. |
| first_indexed | 2024-12-12T16:22:23Z |
| format | Article |
| id | doaj.art-514c4821990645d9837407d819103af0 |
| institution | Directory Open Access Journal |
| issn | 1028-4559 |
| language | English |
| last_indexed | 2024-12-12T16:22:23Z |
| publishDate | 2010-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Taiwanese Journal of Obstetrics & Gynecology |
| spelling | doaj.art-514c4821990645d9837407d819103af02022-12-22T00:18:57ZengElsevierTaiwanese Journal of Obstetrics & Gynecology1028-45592010-12-0149444244810.1016/S1028-4559(10)60096-4Outcomes of High Initial Daily Doses of Gonadotropin in Patients With Poor Ovarian ReserveLi-Ling Chou0Yuh-Ming Hwu1Ming-Huei Lin2Shyr-Yeu Lin3Robert Kuo-Kuang Lee4Department of Obstetrics and Gynecology, Taipei Medical University, Taipei, TaiwanDepartment of Obstetrics and Gynecology, Taipei Medical University, Taipei, TaiwanDepartment of Obstetrics and Gynecology, Taipei Medical University, Taipei, TaiwanDepartment of Obstetrics and Gynecology, Taipei Medical University, Taipei, TaiwanDepartment of Obstetrics and Gynecology, Taipei Medical University, Taipei, TaiwanObjective: To evaluate the in vitro fertilization and intracytoplasmic sperm injection outcomes after high initial doses of follicle-stimulating hormone (FSH) in patients with poor ovarian reserve. Materials and Methods: For in vitro fertilization/intracytoplasmic sperm injection patients younger than 40 years of age, 345 cycles were examined from April 2003 to April 2007. As a control, 218 cycles received gonadotropin-releasing hormone agonist and regular initial doses of FSH from day 3 of the treated cycle. The remaining 127 cycles were treated with high initial doses of FSH with an antagonist or low doses of gonadotropin-releasing hormone because of poor ovarian reserve. Results: When higher initial doses of FSH were used, lower estradiol levels on the day of human chorionic gonadotropin injection and less mature oocytes were retrieved from the group with poor ovarian reserve. Clinical pregnancy rates per embryo transfer were similar (45.7% vs. 48.2%, p = 0.686). There was a trend of lower ongoing pregnancy rate per cycle (28.3% vs. 38.5%, p = 0.05) in the study compared with the control group. In the subgroups with high doses of FSH, neither protocol was superior in terms of clinical (45.5% vs. 46.2%, p=0.952) or ongoing pregnancy rates per embryo transfer (37.9% vs. 42.3%, p=0.695). Conclusion: There was no significant difference in clinical pregnancy rate of the two groups when good embryos were obtained. The group with poor ovarian reserve had lower ongoing pregnancy rates per cycle. For patients with expected poor ovarian response, treatment with high doses of FSH initially is an option.http://www.sciencedirect.com/science/article/pii/S1028455910600964gonadotropinpoor ovarian reservepoor responderpregnancy |
| spellingShingle | Li-Ling Chou Yuh-Ming Hwu Ming-Huei Lin Shyr-Yeu Lin Robert Kuo-Kuang Lee Outcomes of High Initial Daily Doses of Gonadotropin in Patients With Poor Ovarian Reserve Taiwanese Journal of Obstetrics & Gynecology gonadotropin poor ovarian reserve poor responder pregnancy |
| title | Outcomes of High Initial Daily Doses of Gonadotropin in Patients With Poor Ovarian Reserve |
| title_full | Outcomes of High Initial Daily Doses of Gonadotropin in Patients With Poor Ovarian Reserve |
| title_fullStr | Outcomes of High Initial Daily Doses of Gonadotropin in Patients With Poor Ovarian Reserve |
| title_full_unstemmed | Outcomes of High Initial Daily Doses of Gonadotropin in Patients With Poor Ovarian Reserve |
| title_short | Outcomes of High Initial Daily Doses of Gonadotropin in Patients With Poor Ovarian Reserve |
| title_sort | outcomes of high initial daily doses of gonadotropin in patients with poor ovarian reserve |
| topic | gonadotropin poor ovarian reserve poor responder pregnancy |
| url | http://www.sciencedirect.com/science/article/pii/S1028455910600964 |
| work_keys_str_mv | AT lilingchou outcomesofhighinitialdailydosesofgonadotropininpatientswithpoorovarianreserve AT yuhminghwu outcomesofhighinitialdailydosesofgonadotropininpatientswithpoorovarianreserve AT minghueilin outcomesofhighinitialdailydosesofgonadotropininpatientswithpoorovarianreserve AT shyryeulin outcomesofhighinitialdailydosesofgonadotropininpatientswithpoorovarianreserve AT robertkuokuanglee outcomesofhighinitialdailydosesofgonadotropininpatientswithpoorovarianreserve |