Do poor-responder patients undergoing IVF benefit from splitting and increasing the daily gonadotropin dose?

Abstract

We aim to retrospectively evaluate the role of increasing the gonadotropin daily dose from 450 IU/day to 300 IU twice a day on IVF-ET outcome in poor responder patients. All consecutive women admitted to our IVF unit and underwent COH consisting of daily gonadotropin dose of 450 IU, followed by an IVF cycle using 300 IU twice a day, were included. Ovarian stimulation characteristics, number of oocytes retrieved, number of embryo transferred and pregnancy rate was assessed. Twenty-three patients undergoing both cycles were evaluated. While there was no between-group difference in the duration of COH, number of 2PN embryos, fertilization rate and number of embryos transferred, patients receiving daily gonadotropin 300 IU twice a day achieved a significantly higher peak estradiol levels (3350.39 ± 2364.26 vs. 2223.74 ± 1299.91; p < .03, respectively), and yielded significantly higher number of follicles >15 mm in diameter on day of hCG administration (3.2 ± 2.4 vs 1.8 ± 1; p < .03, respectively) and higher number of oocytes retrieved (3.48 ± 2.54 vs 1.87 ± 1.1; p < .02, respectively) with an acceptable live birth rate (5%). To conclude, in poor responders undergoing COH a daily gonadotropin dose of 450 IU, increasing the dose to 300 IU twice daily may result in higher oocyte yield, with the possible improvement in IVF outcome.

摘要

我们的目的是回顾性分析将促性腺激素剂量从450 IU/天增加到300 IU一天2次对低反应患者IVF-ET结局的影响。对于我们IVF中心进行COH的患者进行连续入组, 第一个周期为促性腺激素450 IU/天, 第二个周期促性腺激素为300 IU一天2次。评估卵巢刺激特性、获卵数、胚胎移植数和妊娠率。23名患者接受了两个周期的评估。尽管在COH持续时间、2PN胚胎数、受精率和移植胚胎数方面组间无差异, 但每日两次300IU促性腺激素的患者雌二醇峰值显著升高（3350.39 ± 2364.26 vs. 2223.74 ± 1299.91；P<0.03）。并且HCG日产生的直径大于15mm的卵泡数量明显增加（3.2 ± 2.4 vs 1.8 ± 1；p<0.03）, 获卵数也显著增加（3.48 ± 2.54 vs 1.87 ± 1.1；p<0.02）, 活产率为5%尚可接受。综上所述, 对于每日应用450 IU促性腺激素的卵巢低反应患者, 剂量增加为每日两次促性腺激素300 IU可能会提高获卵数, 可能会提高IVF的结局。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• IVF
• Controlled ovarian hyperstimulation
• gonadotropin daily dose
• poor responders

Disclosure statement

The authors report no conflicts of interest.