Effects of prolonging administration gonadotropin on unexpectedly poor ovarian responders undergoing in vitro fertilizat
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METHODOLOGY
Open Access
Effects of prolonging administration gonadotropin on unexpectedly poor ovarian responders undergoing in vitro fertilization Zhaolian Wei1, Xianxia Cheng1, Huirong Li1, Yunxia Cao1*, Lin Cong1, Ping Zhou1, Jun Li2*
Abstract Background: There are still some patients who show poor response to ovarian stimulation prior to evidence of normal ovarian reserve in vitro fertilization. However, there are few studies about how to treat the unexpectedly ovarian poor responder in vitro fertilization. The main aim of this study evaluate the effect of prolonging administration follicle-stimulating hormone in woman with the unexpectedly ovarian poor responder in vitro fertilization on implantation rate, clinical pregnancy rate and live birth rate. Methods: 922 patients subjected to IVF were divided into two groups according to the predicted criterion of ovarian poor response. 116 patients predicted poor response received the short protocol (group C). The others received the long protocol, among the latter, there were 149 patients undergoing unexpectedly ovarian poor response (group B) and 657 patients exhibited normal ovarian response (group A). The doses of gonadotropin, duration of administration, implantation rate, clinical pregnancy rate and live birth rate were recorded among three groups. Results: The implantation rate of embryo, clinic pregnancy rate and delivery rate are similar between the group A and group B, while there are significant differences between the doses of gonadotropins (35.1 +/- 8.9 ampules vs.53.0 +/- 15.9 ampules) and the duration of administration (15.3 +/- 3.6D vs. 9.8 +/- 2.6D) of these two groups. There are no significant differences about clinical pregnancy rate and live birth rate between group B and group C. Conclusion: Prolonging administration gonadotropin on the unexpectedly poor ovarian responders does not lower live birth rate in vitro fertilization.
Background The success of in vitro fertilization (IVF) depends on careful patient selection and adequate controlled ovarian hyperstimulation. It is estimated that 5%-18% of all IVF cycle are complicated by poor response to ovarian hyperstimulation. Poor response to goandotropin may result in reduction in the pool of embryos available for transfer or cryoperservation, and decrease pregnancy rates. There is still no consensus definition of poor responder [1]. The following criterions had been used to define “poor responders” in practice [2]: No. of mature follicles 40 ampules [3]. It is necessary to identify low responders prior to hormonal treatment for in vitro fertilization-embryo transfer, so that the patients can be counseled regarding the lower chances for pregnancy, more realistic expectations, and cautiously alternative therapies such as oocyte donation or adoption. In addition, stimulation protocols for these patients can be modified to lower the risk of cancellation and improve pregnancy rates. As a result, many screening methods have been proposed to assess prospectively ovarian reserve and individualize treatm
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