High doses of gonadotropins for controlled ovarian hyperstimulation: A case-control study

Abstract : OBJECTIVES: While assisted reproductive technology (ART) activity increases throughout the world, most teams have to face with the challenge of ovarian stimulation in poor responders. Despite a huge amount of literature available, no consensus currently exists on the best protocol, molecule or dose to use in these patients. The main objective of this case-control study was to compare ovarian stimulation and IVF outcome in patients at risk of poor ovarian response undergoing antagonist protocol with high doses of gonadotropins (≥450IU/day) versus patients undergoing stimulation at 300IU/day. METHODS: This retrospective monocentric study was conducted in 2013 on antagonist cycles performed with ≥450IU/day. Each cycle was matched with a control antagonist cycle with 300IU/day injection, with strict matching for ART type, age, serum anti-müllerian hormone (AMH) and body mass index (BMI). RESULTS: A total of 82 high dose cycles were matched and compared with 82 control cycles. Both groups were comparable, except for poor responder prevalence and mean IVF rank, which were higher in high dose group than in control group. No significant difference was observed between the groups in terms of number of oocytes, embryos, fertilization rate, implantation and ongoing pregnancy rates. CONCLUSIONS: No ovarian stimulation protocol has demonstrated its superiority in expected poor responders up to now, especially regarding doses of gonadotropins to use. Accordingly, our study did not show any difference between high dose stimulation regimen (≥450IU/day) and conventional stimulation (300IU/day) in terms of IVF cycle outcome.
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Marine Dercourt, Paul Barriere, Thomas Freour. High doses of gonadotropins for controlled ovarian hyperstimulation: A case-control study. Gynécologie Obstétrique et Fertilité, Elsevier Masson, 2016, 44 (1), pp.29-34. ⟨10.1016/j.gyobfe.2015.09.014⟩. ⟨inserm-02149245⟩

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