scholarly journals Comparison of modified agonist, mild-stimulation and antagonist protocols for in vitro fertilization in patients with diminished ovarian reserve

2018 ◽  
Vol 46 (6) ◽  
pp. 2327-2337 ◽  
Author(s):  
Rong Yu ◽  
Hao Jin ◽  
Xuefeng Huang ◽  
Jinju Lin ◽  
Peiyu Wang
Keyword(s):  
Ovarian Reserve ◽  
Diminished Ovarian Reserve ◽  
Vitro Fertilization ◽  
Protocol Group ◽  
Mild Stimulation ◽  
Group A ◽  
Group B ◽  
Early Abortion ◽  
Antagonist Protocol

Objective To compare the efficacy of three protocols for ovarian stimulation in patients with diminished ovarian reserve during in vitro fertilization (IVF) treatment. Methods This prospective randomized study enrolled patients with diminished ovarian reserve who underwent cycles of IVF or intracytoplasmic sperm injection. The patients were randomly divided into three groups: a modified gonadotrophin releasing hormone (GnRH) agonist protocol (group A); (ii) a mild stimulation protocol (group B); or (iii) an antagonist protocol (group C). Demographic characteristics, clinical variables and pregnancy outcomes were compared between the groups. Results A total of 116 patients were enrolled in the study: 54 in group A, 52 in group B and 60 in group C. Group B (32.69%) had a significantly higher cycle cancellation rate compared with groups A (11.11%) and C (16.67%). The early abortion rate of group C (44.44%) was significantly higher than group A (12.50%), but not significantly different from group B (16.67%). There were no significant differences in the clinical pregnancy rates and live birth rates among the three groups. Conclusion A modified GnRH agonist protocol achieved a comparable pregnancy rate to those of the mild stimulation protocol and antagonist protocol, whilst having lower cycle cancellation and early abortion rates.

scholarly journals GnRH Antagonist Protocol With Cessation of Cetrorelix on Trigger Day Improves Embryological Outcomes for Patients With Sufficient Ovarian Reserve

2021 ◽  
Vol 12 ◽  
Author(s):  
Huihui Xu ◽  
Shen Zhao ◽  
Xinxing Gao ◽  
Xian Wu ◽  
Lan Xia ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Ovarian Reserve ◽  
Gnrh Antagonist ◽  
Young Patients ◽  
Fertilization Rate ◽  
Group A ◽  
Group B ◽  
Antagonist Protocol ◽  
Stimulation Of

ObjectiveTo evaluate the efficiency and validity of cessation of cetrorelix on trigger day during gonadotropin releasing hormone antagonist (GnRH-ant)-controlled ovarian stimulation of in vitro fertilization (IVF) cycles.MethodsIn this retrospective study, a total of 1271 patients undergoing initial IVF cycles following the GnRH-ant protocol were enrolled; 832 patients received cetrorelix on trigger day (Group A) and 439 patients ceased cetrorelix on trigger day (Group B). We compared demographic characteristics, embryological and clinical outcomes between the two groups. A Poisson regression model was used to identify factors that significantly affected embryological outcomes. Patients were further divided into subgroups according to anti-Mullerian hormone (AMH) and age, to assess associations between ceasing cetrorelix on trigger day and embryological outcomes.ResultsThere was a significant improvement on embryological outcomes in patients who ceased cetrorelix on trigger day, and there were no significant differences in clinical outcomes or preovulation rates between the two groups. Furthermore, for patients with 1.1 ≤ AMH ≤ 4.7 ng/ml, all embryological outcomes were significantly higher in Group B compared with Group A. For patients with AMH > 4.7 ng/ml, the number of oocytes retrieved, fertilization rate (2PN) of IVF cycles and proportion of day 3 good quality embryos were all significantly higher in Group B. For patients with age < 35 years, all the embryological outcomes, besides the number of available embryos, were significantly higher in Group B than in Group A. There were no differences in embryological outcomes between the two groups when patients were stratified based on age > 35 years or AMH < 1.1 ng/ml.ConclusionGnRH-ant protocol with cessation of cetrorelix on trigger day improved embryological outcomes for young patients or patients with sufficient ovarian reserve, and was effective at preventing preovulation.

Salivary oestradiol and progesterone after in vitro fertilization and embryo transfer using different luteal support regimens

1990 ◽  
Vol 2 (4) ◽  
pp. 351 ◽  
Author(s):  
YF Wong ◽  
EP Loong ◽  
KR Mao ◽  
PP Tam ◽  
NS Panesar ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Embryo Transfer ◽  
Luteal Phase ◽  
Biologically Active ◽  
Luteal Support ◽  
Vitro Fertilization ◽  
Group A ◽  
Group B ◽  
Ivf Et

Salivary oestradiol (E2) and progesterone (P) levels have been shown to reflect the biologically active fractions in the serum. The luteal-phase status of stimulated cycles was investigated after in vitro fertilization and embryo transfer (IVF-ET). Thirty patients were randomly allocated to one of three luteal therapy groups: group A had no support, group B had intramuscular P and group C had intramuscular P and human chorionic gonadotrophin (hCG). One pregnancy was achieved in group A, two in group B and three in group C. Significant correlations between salivary and serum levels of E2 and of P in matched samples during luteal phase were found. Salivary E2 levels from luteal day 8 through day 14 and P levels from day 3 through day 14 were significantly higher in the pregnant than in the nonpregnant cycles. Among the nonpregnant cycles, salivary E2 and P levels were significantly higher in group C than in group A or B. These findings suggest that, in stimulated cycles for IVF-ET, determination of salivary E2 and P levels may be used as reliable alternatives to serum concentrations for assessing the luteal phase. Also, the additional hCG has an enhanced luteotrophic effect, as reflected by the higher salivary E2 and P levels, which may lead to a better pregnancy rate.

scholarly journals High Serum FSH is Associated with Brown Oocyte Formation and a Lower Pregnacy Rate in Human IVF Parctice

2016 ◽  
Vol 39 (2) ◽  
pp. 677-684 ◽  
Author(s):  
Hongyi Xu ◽  
Kai Deng ◽  
Qingbing Luo ◽  
Juan Chen ◽  
Xin Zhang ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Quality ◽  
High Serum ◽  
Vitro Fertilization ◽  
Good Quality Embryo ◽  
Serum Hormone ◽  
Group A ◽  
Group B ◽  
Ivf Et

Background/Aims: To investigate whether brown zona pellucida (ZP) of oocytes affects the outcome of fertilization, embryo quality and pregnancy rate in in vitro fertilization-embryo transfer (IVF-ET). Methods: Based on the ZP color of their oocytes, a total number of 703 patients dated from 2012 to 2014 were divided into a normal egg group (group A) and a brown oocyte group (group B), with 629 and 74 cases, respectively. Clinical characteristics, gonadotropin (Gn) days, Gn dosage, serum hormone levels on the day of human chorionic gonadotropin (HCG) injection, ZP thickness (ZPT) of the eggs, fertilization rate, rescue intracytoplasmic sperm injection (rICSI) rate, good-quality embryo rate and pregnancy rate were compared between the two groups. Results: No significant differences were found in the duration and the causes of infertility, and their basal level of endocrine hormone before IVF-ET between normal egg group and brown egg group. The level of serum hormone including estradiol, progesterone and luteinizing hormone on the day of HCG injection were again similar. Moreover, there were no differences in number of mature oocytes, oocyte fertilization rates and rICSI rates after IVF between the two groups. However, we observed that the ZPT of brown oocytes (group B) was higher than that of normal oocytes (group A). Moreover, the Gn dosage and FSH levels on the day of HCG injection were significantly higher in group B than in group A and the good-quality embryo rate and pregnancy rate in group B were lower than those in group A. Conclusion: Compared with normal eggs, oocytes with a brown ZP were found to have a higher ZPT, lower embryo quality and lower pregnancy rate, which might be due to a high Gn dosage injection and high serum FSH levels during IVT-ET cycles.

scholarly journals Surgical diminished ovarian reserve after endometrioma cystectomy versus idiopathic DOR: comparison of in vitro fertilization outcome

2015 ◽  
Vol 30 (4) ◽  
pp. 840-847 ◽  
Author(s):  
A. Roustan ◽  
J. Perrin ◽  
M. Debals-Gonthier ◽  
O. Paulmyer-Lacroix ◽  
A. Agostini ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Ovarian Reserve ◽  
Diminished Ovarian Reserve ◽  
Vitro Fertilization

scholarly journals Success rate of intrauterine insemination in patients with unknown infertility

2012 ◽  
Vol 69 (4) ◽  
pp. 301-307 ◽  
Author(s):  
Vladimir Jasovic ◽  
Emilija Jasovic-Siveska
Keyword(s):  
Success Rate ◽  
Negative Impact ◽  
Intrauterine Insemination ◽  
Unexplained Infertility ◽  
Mild Form ◽  
Vitro Fertilization ◽  
Group A ◽  
Group B ◽  
Twin Pregnancies

Background/Aim. Unknown cause of infertility exists in 10%-26% of couples with infertility problems. Treatment of these couples depends on the possibility of correcting the unidentified defect over time. Intrauterine insemination (IUI) and ovaluation stimulation are methods of choice in treatment of unexplained fertility, but if a woman is older than 37 years, in vitro fertilization (IVF) could be directly recommended. The aim of this research was to compare the success rate of pregnancies with IUI between the patients with unexplained infertility and the patients with mild form endometriosis. Methods. The study included on 50 patients diagnosed with mild form endometriosis (group A) and 50 patients with unknown cause infertility (group B). Using the same therapeutical protocol, human menopausal gonadothropin (hMG) stimulation and horionic gonadropin (hCG) induction were applied, as well as IUI. Results. The percentage of achieved ovulation was higher in the group B (p < 0.05). During the 3 simulated sequential periods 102 IUI were performed in the group A and 97 IUI in the group B. In the group A there were 6 single and 1 twin pregnancies sucesfully conceived (14%), while in group B there were 9 (18%) single pregnancies. Conclusion. The use of a combination of controled ovarian hyperstimulation and IUI is an effective, cheap and safe method for treating infertility couples, especially couples with unknown cause infertility. Mild form endometriosis, as etiological infertility factor, has a negative impact on IUI success rate.

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