Assisted Reproductive Technology (ART) Ovarian Stimulation Protocols: GnRH Antagonists and Protocols to Decrease Patient Risk

Purpose.To improve success of in vitro fertilization (IVF), assisted reproductive technology (ART) experts addressed four questions. What is optimum oocytes number leading to highest live birth rate (LBR)? Are cohort size and embryo quality correlated? Does gonadotropin type affect oocyte yield? Should “freeze-all” policy be adopted in cycles with progesterone >1.5 ng/mL on day of human chorionic gonadotropin (hCG) administration?Methods.Electronic database search included ten studies on which panel gave opinions for improving current practice in controlled ovarian stimulation for ART.Results.Strong association existed between retrieved oocytes number (RON) and LBRs. RON impacted likelihood of ovarian hyperstimulation syndrome (OHSS). Embryo euploidy decreased with age, not with cohort size. Progesterone > 1.5 ng/dL did not impair cycle outcomes in patients with high cohorts and showed disparate results on day of hCG administration.Conclusions.Ovarian stimulation should be designed to retrieve 10–15 oocytes/treatment. Accurate dosage, gonadotropin type, should be selected as per prediction markers of ovarian response. Gonadotropin-releasing hormone (GnRH) antagonist based protocols are advised to avoid OHSS. Cumulative pregnancy rate was most relevant pregnancy endpoint in ART. Cycles with serum progesterone ≥1.5 ng/dL on day of hCG administration should not adopt “freeze-all” policy. Further research is needed due to lack of data availability on progesterone threshold or index.

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A common polymorphic allele of the LH beta-subunit gene is associated with higher exogenous FSH consumption during controlled ovarian stimulation for assisted reproductive technology

Reproductive Biology and Endocrinology ◽

10.1186/1477-7827-11-51 ◽

2013 ◽

Vol 11 (1) ◽

pp. 51 ◽

Cited By ~ 38

Author(s):

Carlo Alviggi ◽

Kim Pettersson ◽

Salvatore Longobardi ◽

Claus Andersen ◽

Alessandro Conforti ◽

...

Keyword(s):

Assisted Reproductive Technology ◽

Ovarian Stimulation ◽

Reproductive Technology ◽

Beta Subunit ◽

Controlled Ovarian Stimulation ◽

Subunit Gene ◽

Polymorphic Allele ◽

Beta Subunit Gene

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Pergoveris in controlled ovarian stimulation in assisted reproductive technology programms

Reproductive Endocrinology ◽

10.18370/2309-4117.2013.13.56-60 ◽

2013 ◽

Vol 0 (13) ◽

pp. 56

Author(s):

В. В. Веселовский

Keyword(s):

Assisted Reproductive Technology ◽

Ovarian Stimulation ◽

Reproductive Technology ◽

Controlled Ovarian Stimulation

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Analysis of the clinical efficiency of human menopausal gonadotropins in the assisted reproductive technology program

Medical Council ◽

10.21518/2079-701x-2021-13-34-41 ◽

2021 ◽

pp. 34-41

Author(s):

Yu. A. Drapkina ◽

N. P. Makarova ◽

V. Yu. Smolnikova

Keyword(s):

Assisted Reproductive Technology ◽

Ovarian Stimulation ◽

Ovarian Function ◽

Laboratory Data ◽

Reproductive Technology ◽

Gonadotropin Releasing Hormone ◽

Human Menopausal Gonadotropin ◽

Technology Program ◽

Releasing Hormone ◽

Technology Programs

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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