Outcomes after early or midfollicular phase LH supplementation in previous inadequate responders
Received 26 February 2009; received in revised form 18 March 2009; accepted 16 November 2009. published online 21 January 2010.
Abstract
Second cycle outcomes of 75 patients who had previous inadequate ovarian response with recombinant FSH (rFSH)-only ovarian stimulation during gonadotrophin-releasing hormone analogue (GnRHa) down-regulated cycles were evaluated retrospectively. In these second cycles, both rFSH and human menopausal gonadotrophin (HMG) in GnRHa long down-regulation were given to all patients, HMG initiated either on day 1 (group A, n=37) or day 5–6 of the ovarian stimulation (group B, n=38). Total HMG dose was higher (1198±514 IU versus 726±469IU; P<0.001), cumulative rFSH consumption was lower (1823±804 IU versus 2863±1393IU; P=0.001) and duration of stimulation was shorter (8.94±1.15days versus 10.37±1.80days; P<0.001) in group A than in group B. No significant differences were found regarding fertilization, implantation or pregnancy rates and embryo quality between the groups. Further analysis by supplementary HMG dose (75IU versus 150IU) revealed that total gonadotrophin and HMG consumption was lower in 75IU-supplemented subgroups. Notably, pregnancy rate was higher in patients where 75IU HMG was supplemented on day 5–6 of ovarian stimulation, which deserves further evaluation.
Declaration: The authors report no financial or commercial conflicts of interest.
aIVF Unit, Department of Obstetrics and Gynecology, School of Medicine, Ankara University, Ankara, Turkey
bCenter for Research on Human Reproduction (USAUM), Ankara University, Ankara, Turkey
cDepartment of Obstetrics and Gynecology, Faculty of Medicine, Fatih University, Istanbul, Turkey
Corresponding author.
Dr Sonmezer has been working on reproductive medicine at Ankara University, School of Medicine, Department of Obstetrics and Gynaecology, and Center for Research on Human Reproduction. He completed a research doctorate program on assisted reproduction at the University of Cornell-USA under the supervision of Professor Dr Kutluk Oktay. He is interested in human oocyte and ovarian tissue cryopreservation, sperm DNA damage and ovulation induction in poor responders.
ABSTRACT
Dr Sonmezer has been working on reproductive medicine at Ankara University, School of Medicine, Department of Obstetrics and Gynaecology, and Center for Research on Human Reproduction. He completed a research doctorate program on assisted reproduction at the University of Cornell-USA under the supervision of Professor Dr Kutluk Oktay. He is interested in human oocyte and ovarian tissue cryopreservation, sperm DNA damage and ovulation induction in poor responders.