Intraovarian Injection of Recombinant Human Follicle-Stimulating Hormone for Luteal-Phase Ovarian Stimulation during Oocyte Retrieval Is Effective in Women with Impending Ovarian Failure and Diminished Ovarian Reserve

It is a challenge to obtain sufficient eggs during in vitro fertilization (IVF) in women with impending ovarian failure (IOF)/diminished ovarian reserve (DOR). Although studies have suggested that more than one wave of follicle growth exists, the efficacy of controlled ovulation stimulation (COS) in...

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Main Authors: Chao-Chin Hsu, Isabel Hsu, Li-Hsuan Lee, Yuan-Shuo Hsueh, Chih-Ying Lin, Hui Hua Chang
Format: Article
Language:English
Published: MDPI AG 2022-06-01
Series:Biomedicines
Subjects:
Online Access:https://www.mdpi.com/2227-9059/10/6/1312
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author Chao-Chin Hsu
Isabel Hsu
Li-Hsuan Lee
Yuan-Shuo Hsueh
Chih-Ying Lin
Hui Hua Chang
author_facet Chao-Chin Hsu
Isabel Hsu
Li-Hsuan Lee
Yuan-Shuo Hsueh
Chih-Ying Lin
Hui Hua Chang
author_sort Chao-Chin Hsu
collection DOAJ
description It is a challenge to obtain sufficient eggs during in vitro fertilization (IVF) in women with impending ovarian failure (IOF)/diminished ovarian reserve (DOR). Although studies have suggested that more than one wave of follicle growth exists, the efficacy of controlled ovulation stimulation (COS) in both follicular and luteal phases of the same ovarian cycle (DuoStim) is not established in women with IOF/DOR. We investigated the efficacy of DuoStim using the intraovarian injection of recombinant human follicle-stimulating hormone (rhFSH) during oocyte retrieval in women with DOR. For luteal-phase stimulation, intraovarian (Group A, N = 28) or superficial subcutaneous (Group B, N = 18) injection of 300 IU rhFSH immediately after oocyte retrieval was administered as the first dose, and intermittent superficial subcutaneous addition of gonadotropins was employed accordingly for further COS in both groups. In Group A, significantly lower Gn doses, a shorter duration of COS, a greater number of antral follicle counts, and an increased number of retrieved mature and total oocytes were noted. Compared with the clinical outcomes of luteal-phase COS, the average daily doses of rhFSH used in Group A were significantly lower. In summary, the novel approach using intraovarian rhFSH injection provides an efficient treatment regimen in women with IOF/DOR.
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spelling doaj.art-c61c7fccfdfc46b3b00fbef8eae2fde52023-11-23T15:42:35ZengMDPI AGBiomedicines2227-90592022-06-01106131210.3390/biomedicines10061312Intraovarian Injection of Recombinant Human Follicle-Stimulating Hormone for Luteal-Phase Ovarian Stimulation during Oocyte Retrieval Is Effective in Women with Impending Ovarian Failure and Diminished Ovarian ReserveChao-Chin Hsu0Isabel Hsu1Li-Hsuan Lee2Yuan-Shuo Hsueh3Chih-Ying Lin4Hui Hua Chang5Taiwan United Birth-Promoting Experts Fertility Clinic, Tainan 710, TaiwanDepartment of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei 100, TaiwanNepean Hospital, Penrith, NSW 2747, AustraliaDepartment of Medical Science Industries, College of Health Sciences, Chang Jung Christian University, Tainan 711, TaiwanInstitute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan 701, TaiwanInstitute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan 701, TaiwanIt is a challenge to obtain sufficient eggs during in vitro fertilization (IVF) in women with impending ovarian failure (IOF)/diminished ovarian reserve (DOR). Although studies have suggested that more than one wave of follicle growth exists, the efficacy of controlled ovulation stimulation (COS) in both follicular and luteal phases of the same ovarian cycle (DuoStim) is not established in women with IOF/DOR. We investigated the efficacy of DuoStim using the intraovarian injection of recombinant human follicle-stimulating hormone (rhFSH) during oocyte retrieval in women with DOR. For luteal-phase stimulation, intraovarian (Group A, N = 28) or superficial subcutaneous (Group B, N = 18) injection of 300 IU rhFSH immediately after oocyte retrieval was administered as the first dose, and intermittent superficial subcutaneous addition of gonadotropins was employed accordingly for further COS in both groups. In Group A, significantly lower Gn doses, a shorter duration of COS, a greater number of antral follicle counts, and an increased number of retrieved mature and total oocytes were noted. Compared with the clinical outcomes of luteal-phase COS, the average daily doses of rhFSH used in Group A were significantly lower. In summary, the novel approach using intraovarian rhFSH injection provides an efficient treatment regimen in women with IOF/DOR.https://www.mdpi.com/2227-9059/10/6/1312diminished ovarian reserveimpending ovarian failureintraovarianluteal phaserecombinant human follicle-stimulating hormonecontrolled ovulation stimulation
spellingShingle Chao-Chin Hsu
Isabel Hsu
Li-Hsuan Lee
Yuan-Shuo Hsueh
Chih-Ying Lin
Hui Hua Chang
Intraovarian Injection of Recombinant Human Follicle-Stimulating Hormone for Luteal-Phase Ovarian Stimulation during Oocyte Retrieval Is Effective in Women with Impending Ovarian Failure and Diminished Ovarian Reserve
Biomedicines
diminished ovarian reserve
impending ovarian failure
intraovarian
luteal phase
recombinant human follicle-stimulating hormone
controlled ovulation stimulation
title Intraovarian Injection of Recombinant Human Follicle-Stimulating Hormone for Luteal-Phase Ovarian Stimulation during Oocyte Retrieval Is Effective in Women with Impending Ovarian Failure and Diminished Ovarian Reserve
title_full Intraovarian Injection of Recombinant Human Follicle-Stimulating Hormone for Luteal-Phase Ovarian Stimulation during Oocyte Retrieval Is Effective in Women with Impending Ovarian Failure and Diminished Ovarian Reserve
title_fullStr Intraovarian Injection of Recombinant Human Follicle-Stimulating Hormone for Luteal-Phase Ovarian Stimulation during Oocyte Retrieval Is Effective in Women with Impending Ovarian Failure and Diminished Ovarian Reserve
title_full_unstemmed Intraovarian Injection of Recombinant Human Follicle-Stimulating Hormone for Luteal-Phase Ovarian Stimulation during Oocyte Retrieval Is Effective in Women with Impending Ovarian Failure and Diminished Ovarian Reserve
title_short Intraovarian Injection of Recombinant Human Follicle-Stimulating Hormone for Luteal-Phase Ovarian Stimulation during Oocyte Retrieval Is Effective in Women with Impending Ovarian Failure and Diminished Ovarian Reserve
title_sort intraovarian injection of recombinant human follicle stimulating hormone for luteal phase ovarian stimulation during oocyte retrieval is effective in women with impending ovarian failure and diminished ovarian reserve
topic diminished ovarian reserve
impending ovarian failure
intraovarian
luteal phase
recombinant human follicle-stimulating hormone
controlled ovulation stimulation
url https://www.mdpi.com/2227-9059/10/6/1312
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