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Reprod Biomed Online. 2018 Oct;37(4):434-441. doi: 10.1016/j.rbmo.2018.07.007. Epub 2018 Aug 23.

Conventional versus minimal ovarian stimulation: an intra-patient comparison of ovarian response in poor-responder women according to Bologna Criteria.

Author information

1
IVI-RMA Global, Plaza Policía Local, Valencia3. 46015, Spain. Electronic address: elena.labarta@ivirma.com.
2
IVI-RMA Global, Plaza Policía Local, Valencia3. 46015, Spain; Thomas Jefferson University, Philadelphia, USA.
3
IVI-RMA Global, Plaza Policía Local, Valencia3. 46015, Spain.

Abstract

RESEARCH QUESTION:

Is minimal ovarian stimulation (MOS) as effective as conventional ovarian stimulation (COS) in ovarian response and embryo quality in the same 46 poor-responder patients according to the Bologna criteria?

DESIGN:

An intra-patient comparison of patients undergoing both protocols. Ovaries were stimulated with either a gonadotrophin-releasing hormone antagonist protocol and a combination of recombinant FSH and highly purified human menotrophin (HP-HMG) daily (COS), or with the use of clomiphene citrate 50 mg daily and 150 IU of HP-HMG or recombinant FSH every other day from simulation day 4 (MOS).

RESULTS:

After MOS, significantly more good-quality embryos (1.0 ± 1.2 versus 0.3 ± 0.6) (P = 0.002), oocytes (3.2 ± 1.9 versus 2.0 ± 1.8) (P = 0.002), and mature (metaphase II) oocytes (2.6 ± 1.7 versus 1.6 ± 1.7) (P = 0.001) were obtained. In COS cycles, a significantly higher total gonadotrophin dose was needed per good-quality embryo (+2194 IU; 95% CI 618 to 3170).

CONCLUSIONS:

In poor responder patients, MOS is a good alternative when COS has failed, or even as a first-line treatment. It offered a significantly greater number of good-quality embryos as well as a higher number of oocytes, using significantly lower doses of gonadotrophins per oocyte and embryo obtained.

KEYWORDS:

Bologna criteria; Clomiphene citrate; Conventional stimulation; Minimal ovarian stimulation; Poor responder patients

PMID:
30219283
DOI:
10.1016/j.rbmo.2018.07.007

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