Potential implications of gonadotropin-releasing hormone analogues in assisted reproductive technology

Introduction. Comparative analysis of urinary and recombinant gonadotropins is ongoing to improve the efficiency of assisted reproductive technology programs. Particular interest focused on the identification of individual groups of patients with maximal efficacy of using certain ovarian stimulation drugs in an assisted reproductive technology program.Objective. To review the application of Menopur Multidose 1200 IU for ovarian stimulation in assisted reproductive technology protocols with gonadotropin-releasing hormone agonists (GnRH) or gonadotropin-releasing hormone antagonists (GnRH antagonists) in the current clinical practice.Materials and methods. The study retrospectively enrolled 4,080 women aged 20-43 years. Ovarian stimulation in the Assisted Reproductive Technology program was performed using the GnRH antagonist protocol in 65.8% of patients and the GnRH agonist protocol with Menopur Multidose 1200 IU with or without the additional Menopur 75 IU in 34.2% of women.Results. Clinical and laboratory data of the patients, stimulated cycle parameters, characteristics of the embryological stage, and results of the assisted reproductive technology program were analyzed. The frequency of obtaining degenerated oocytes did not exceed 5%. The relative number of blastocysts of good quality was 59.9%, while for patients in the older age group, the figure was 54.6. The average pregnancy rate in patients in the “Menopur Multidose 1200 IU p/k” group was 39.3%, which corresponds to high-performance indicators of the assisted reproductive technology program.Conclusions. Administration of highly purified human menopausal gonadotropin (hMG) (Menopur Multidose 1200 IU) to stimulate ovarian function in patients of different ages is accompanied by an adequate number of mature oocytes, good quality blastocysts, and satisfactory clinical pregnancy rates. Thus, highly purified human menopausal gonadotropin is not inferior to recombinant follicle-stimulating hormone(r-FSH) concerning the efficacy of assisted reproductive technology programs.

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In Vitro Fertilization

10.2310/obg.19099 ◽

2018 ◽

Author(s):

Jessica R Zolton ◽

Rhea Chattopadhyay ◽

Alan H. DeCherney

Keyword(s):

In Vitro Fertilization ◽

Assisted Reproductive Technology ◽

Ovarian Reserve ◽

Intracytoplasmic Sperm Injection ◽

Reproductive Technology ◽

Gonadotropin Releasing Hormone ◽

The Body ◽

Vitro Fertilization ◽

Releasing Hormone

Assisted reproductive technology (ART) encompasses all procedures that manipulate the oocytes, sperm, and embryos outside of the body. Decades of research have allowed the field to emerge as a reliable and safe treatment for infertile men and women. Indications for in vitro fertilization (IVF) include tubal factor infertility, anovulation, male factor infertility, and decreased ovarian reserve. Treatment is not limited to the infertile population, as IVF with preimplantation genetic diagnosis also offers patients an opportunity to prevent transmission of a genetic condition for which they have been found to carry. The field of ART continues to rapidly evolve, as more knowledge is gained from studies reporting on ovarian stimulation protocols, reproductive techniques such as intracytoplasmic sperm injection, and blastocyst transfer. Techniques are aimed to improve live birth rates while ensuring the optimal health of children conceived using IVF. This review contains 8 figures, 5 tables and 63 references Key Words: assisted reproductive technology, blastocyst, decreased ovarian reserve, embryo transfer, gonadotropin-releasing hormone agonist, gonadotropin-releasing hormone antagonist, intracytoplasmic sperm injection, luteal phase support, ovarian hyperstimulation syndrome, vitrification

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