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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MDPI AG
2022-06-01
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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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