Length of ovarian stimulation does not impact live birth rate in fresh donor oocyte cycles: a SART CORS study
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ASSISTED REPRODUCTION TECHNOLOGIES
Length of ovarian stimulation does not impact live birth rate in fresh donor oocyte cycles: a SART CORS study Alexa Cohen 1 & Michelle Kappy 1 & Melissa Fazzari 1 & Rachel S. Gerber 1 & Sharon Galperin 1 & Harry Lieman 1 & Sangita Jindal 1 & Erkan Buyuk 1,2 Received: 17 June 2020 / Accepted: 6 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To evaluate the effect of controlled ovarian hyperstimulation length and total gonadotropin (GN) dose on recipient live birth rate (LBR) in fresh donor oocyte cycles. Methods Data was obtained from SART CORS on all fresh donor oocyte GnRH antagonist cycles (n = 1049) between 2014 and 2015 which resulted in a single embryo transferred. Donor and recipient demographic information and cycle characteristics were extracted. Binomial regression was used to estimate LBR with respect to days of stimulation (DOS) and total GN dose. Multivariate analysis was performed to evaluate these relationships after controlling for confounders. Results Overall LBR in fresh donor oocyte cycles was 57%. Average stimulation length was 14.3 ± 4.9 days, and total GN dose was 2464 ± 1062 IU. On univariate analysis, neither days of stimulation (p = 0.5) nor total GN dose (p = 0.57) was independently correlated with LBR. However, in prolonged stimulations (> 15 days) with high total GN dose (> 3000 IU), as both the cycle length and total GN dose increased, LBR significantly decreased from 63.81 to 48.15% (p = 0.02) and from 67.61 to 48.15% (p = 0.01), respectively. Multivariate analysis showed no significant effect of either DOS or total GN dose on LBR. Conclusions LBR is significantly decreased in fresh donor oocyte cycles when cycles are prolonged with high total GN dose. However, after controlling for confounders neither DOS nor total GN dose significantly affects LBR. Keywords In vitro fertilization . Live birth rate . Controlled ovarian hyperstimulation . Gonadotropin dose . Prolonged ovarian stimulation . Donor
Introduction In vitro fertilization (IVF) with oocyte donation is a popular option for patients unable to conceive with autologous oocytes. In 2016, there were 8973 donor oocyte transfer cycles in the USA with 62.9% using fresh donor oocytes and the remainder using frozen donor oocytes [1]. Despite increasing popularity in frozen donor oocyte cycles and improvements in both freeze and thaw techniques, studies show mixed results
* Erkan Buyuk [email protected] 1
Albert Einstein College of Medicine/Montefiore Medical Center, 1300 Morris Park Avenue, 6th floor, Bronx, NY 10461, USA
2
Reproductive Medicine associates of New York, Icahn School of Medicine at Mount Sinai, 635 Madison Avenue, 10th floor, New York, NY 10022, USA
in live birth rates (LBR) in fresh versus frozen donor oocyte cycles, and fresh continues to be the primary method employed in this population [2]. Additionally, a recent SART study showed improved perinatal outcomes in fresh versus frozen donor oocyte cycles [3]. Given the limited ava
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