Is there a detrimental effect of higher gonadotrophin dose on clinical pregnancy rate in normo-responders undergoing ART with long protocol?

Arch Gynecol Obstet. 2013 May;287(5):1039-44. doi: 10.1007/s00404-012-2673-z. Epub 2012 Dec 13.

Abstract

Background: In recent years, it has become evident that ovarian stimulation, although a central component of in vitro fertilization (IVF), may itself has detrimental effects on oogenesis, embryo quality, endometrial receptivity, and perhaps also perinatal outcomes.

Objective: To evaluate the effect of higher gonadotrophin dose on clinical pregnancy rate in normo-responder ICSI cycles with long protocol.

Methods: A retrospective study was planned in the Department of Reproductive Endocrinology of Zekai Tahir Burak Women's Health Education and Research Hospital. 362 normo-responders undergoing ICSI cycles with long protocol were included in the study. Group 1 (n = 260): Total gonadotrophin dose <2198 IU and Group 2 (n = 102): Total gonadotrophin dose >2198 IU. Laboratory IVF outcome, clinical pregnancy rate were evaluated.

Result(s): There was no statistically significant difference between peak estradiol levels, endometrial thickness, fertilization rates among the Group 1 versus Group 2 (p > 0.05). But there was a statistically significant difference in age, baseline FSH, oocyte number, 2PN, and clinical pregnancy among the Group 1 versus Group 2. Clinical pregnancy rate were significantly higher in Group 1 compared with Group 2 (p < 0.001). Lower gonadotrophin dose, 2PN was an independent positive predictor of clinical pregnancy (OR 2.65 for gonadotrophin dose, OR 1.1 for 2PN) CONCLUSION(S): Higher total gonadotrophin dose adversely affect clinical pregnancy in normo-responder patients undergoing ICSI cycles with long protocol.

MeSH terms

  • Body Mass Index
  • Chorionic Gonadotropin / administration & dosage
  • Dose-Response Relationship, Drug
  • Embryo Transfer
  • Estradiol / blood
  • Female
  • Follicle Stimulating Hormone / administration & dosage
  • Follicle Stimulating Hormone / blood
  • Gonadotropin-Releasing Hormone / agonists
  • Gonadotropins / administration & dosage*
  • Gonadotropins / adverse effects*
  • Humans
  • Leuprolide / administration & dosage
  • Oocytes
  • Ovulation Induction / methods
  • Pregnancy
  • Recombinant Proteins / administration & dosage
  • Retrospective Studies
  • Sperm Injections, Intracytoplasmic / methods*
  • Tissue and Organ Harvesting
  • Treatment Outcome
  • Turkey

Substances

  • Chorionic Gonadotropin
  • Gonadotropins
  • Recombinant Proteins
  • Gonadotropin-Releasing Hormone
  • Estradiol
  • Follicle Stimulating Hormone
  • Leuprolide