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Fertil Steril. 2004 Apr;81(4):1002-6.

Minimal stimulation using recombinant follicle-stimulating hormone and a gonadotropin-releasing hormone antagonist in women of advanced age.

Author information

1
Wunschbabyzentrum Institute for Sterility Treatment, Vienna, Austria.

Abstract

OBJECTIVE:

To determine whether minimal stimulation with short-term application of low-dose recombinant follicle-stimulating hormone (FSH) together with a gonadotropin-releasing hormone (GnRH) antagonist represents a cost-effective treatment regimen for patients with elevated FSH levels, aged 40 and above.

DESIGN:

Retrospective cohort study.

SETTING:

Academically affiliated private in vitro fertilization (IVF) program.

PATIENT(S):

Eighty-five IVF cycles using minimal ovarian stimulation and 85 cycles with a standard long-stimulation protocol, conducted between January 2000 and January 2002, in women aged 40 and above who had slightly increased FSH levels.

INTERVENTION(S):

Patients on the long protocol underwent standard cycle monitoring and stimulation. In contrast, women with minimal stimulation had transvaginal sonography initiated on day 8 of the menstrual cycle and at a follicle size of 13 mm. We administered 0.25 mg of GnRH antagonist and 75 IU recombinant FSH daily until ovulation induction.

MAIN OUTCOME MEASURE(S):

Numbers of oocytes, and rates of cancellation and pregnancy.

RESULT(S):

Minimal stimulation cycles resulted in a clinical pregnancy rate of 8.2% per started cycle and 10% per embryo transfer (ET), whereas the control group yielded a clinical pregnancy rate of 10.6% per started cycle and of 10.7% per ET (not statistically significant).

CONCLUSION(S):

In women aged 40 and above with abnormal FSH levels, minimal stimulation protocol achieves similar pregnancy rates to a standard protocol, and thus represents a cost-effective alternative.

[Indexed for MEDLINE]

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