Conventional versus minimal ovarian stimulation: an intra-patient comparison of ovarian response in poor-responder women according to Bologna Criteria

被引:13
作者
Labarta, Elena [1 ]
Marin, Diego [1 ,2 ]
Remohi, Jose [1 ]
Bosch, Ernesto [1 ]
机构
[1] IVI RMA Global, Plaza Policia Local 3, Valencia 46015, Spain
[2] Thomas Jefferson Univ, Philadelphia, PA 19107 USA
关键词
Bologna criteria; Clomiphene citrate; Conventional stimulation; Minimal ovarian stimulation; Poor responder patients; IN-VITRO FERTILIZATION; NATURAL CYCLE; COST-EFFECTIVENESS; VITRIFIED OOCYTES; CONTROLLED-TRIAL; EMBRYO-TRANSFER; LIVE BIRTH; IVF; STRATEGY; HYPERSTIMULATION;
D O I
10.1016/j.rbmo.2018.07.007
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Research question: Is minimal ovarian stimulation (MOS) as effective as conventional ovarian stimulation (COS) in ovarian response and embryo quality in the same 46 poor-responder patients according to the Bologna criteria? Design: An intra-patient comparison of patients undergoing both protocols. Ovaries were stimulated with either a gonadotrophin-releasing hormone antagonist protocol and a combination of recombinant FSH and highly purified human menotrophin (HP-HMG) daily (COS), or with the use of clomiphene citrate 50 mg daily and 150 IU of HP-HMG or recombinant FSH every other day from simulation day 4 (MOS). Results: After MOS, significantly more good-quality embryos (1.0 +/- 1.2 versus 0.3 +/- 0.6) (P = 0.002), oocytes (3.2 +/- 1.9 versus 2.0 +/- 1.8) (P = 0.002), and mature (metaphase II) oocytes (2.6 +/- 1.7 versus 1.6 +/- 1.7) (P = 0.001) were obtained. In COS cycles, a significantly higher total gonadotrophin dose was needed per good-quality embryo (+ 2194 IU; 95% CI 618 to 3170). Conclusions: In poor responder patients, MOS is a good alternative when COS has failed, or even as a first-line treatment. It offered a significantly greater number of good-quality embryos as well as a higher number of oocytes, using significantly lower doses of gonadotrophins per oocyte and embryo obtained.
引用
收藏
页码:434 / 441
页数:8
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