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• W2015013605 abstract "ObjectiveTo investigate if a specific low responder controlled ovarian hyperstimulation (COH) protocol results in superior pregnancy outcomes in anticipated low responder women of favorable age groups (< 38 yo) during first fresh IVF attempt.DesignRetrospective cohort study in a tertiary academic center.Materials and MethodsA total of 1164 consecutive IVF cycles were reviewed from Jan 05 - Dec 10. All 322 initial fresh IVF attempts utilizing low responder protocol [GnRH antagonist (ANT) or GnRH agonist flare (FL)] were reviewed. Low responders were defined by ovarian reserve testing (Basal FSH and AFC) and protocols chosen by the patient's physician. Patient demographics, IVF cycle characteristics, and pregnancy outcomes of both groups were analyzed using SPSS.ResultsTwo hundred seventy-two IVF cycles were analyzed according to inclusion criteria [ANT-N = 146 (53.7%); FL-N = 126 (46.3%)] and 85.7% of the cycles went to ET (ANT = 89.7 and FL = 81.0%). Respective demographic characteristics including mean age, BMI, number of prior superovulation/intrauterine inseminations, gravidity, and parity were similar between both groups. The AFC was higher (7.06 ± 2.36 vs. 8.87 ± 3.15, P<0.0001) and day 3 FSH level lower (10.40 ± 3.80 vs. 8.17 ± 2.32, P<0.0001) in the ANT group. After controlling for day 3 AFC and FSH, the ANT group demonstrated a greater ovarian response and produced higher quality embryos compared to FL group. The overall clinical pregnancy and live birth rates in both groups were similar but subanalysis of the patients younger than 36 years old revealed that cycles of ANT group were more likely to result in live birth than the FL group [23 (42.6%), vs.12(22.2%), P=0.02].ConclusionWhen controlling for ovarian reserve testing in women of favorable age prognosis groups, a specific subgroup of women < 36 years of age with anticipated low responder status demonstrated superior ovarian response, embryo cohort quality and pregnancy outcomes with ANT protocol compared to FL during first fresh IVF attempt. ObjectiveTo investigate if a specific low responder controlled ovarian hyperstimulation (COH) protocol results in superior pregnancy outcomes in anticipated low responder women of favorable age groups (< 38 yo) during first fresh IVF attempt. To investigate if a specific low responder controlled ovarian hyperstimulation (COH) protocol results in superior pregnancy outcomes in anticipated low responder women of favorable age groups (< 38 yo) during first fresh IVF attempt. DesignRetrospective cohort study in a tertiary academic center. Retrospective cohort study in a tertiary academic center. Materials and MethodsA total of 1164 consecutive IVF cycles were reviewed from Jan 05 - Dec 10. All 322 initial fresh IVF attempts utilizing low responder protocol [GnRH antagonist (ANT) or GnRH agonist flare (FL)] were reviewed. Low responders were defined by ovarian reserve testing (Basal FSH and AFC) and protocols chosen by the patient's physician. Patient demographics, IVF cycle characteristics, and pregnancy outcomes of both groups were analyzed using SPSS. A total of 1164 consecutive IVF cycles were reviewed from Jan 05 - Dec 10. All 322 initial fresh IVF attempts utilizing low responder protocol [GnRH antagonist (ANT) or GnRH agonist flare (FL)] were reviewed. Low responders were defined by ovarian reserve testing (Basal FSH and AFC) and protocols chosen by the patient's physician. Patient demographics, IVF cycle characteristics, and pregnancy outcomes of both groups were analyzed using SPSS. ResultsTwo hundred seventy-two IVF cycles were analyzed according to inclusion criteria [ANT-N = 146 (53.7%); FL-N = 126 (46.3%)] and 85.7% of the cycles went to ET (ANT = 89.7 and FL = 81.0%). Respective demographic characteristics including mean age, BMI, number of prior superovulation/intrauterine inseminations, gravidity, and parity were similar between both groups. The AFC was higher (7.06 ± 2.36 vs. 8.87 ± 3.15, P<0.0001) and day 3 FSH level lower (10.40 ± 3.80 vs. 8.17 ± 2.32, P<0.0001) in the ANT group. After controlling for day 3 AFC and FSH, the ANT group demonstrated a greater ovarian response and produced higher quality embryos compared to FL group. The overall clinical pregnancy and live birth rates in both groups were similar but subanalysis of the patients younger than 36 years old revealed that cycles of ANT group were more likely to result in live birth than the FL group [23 (42.6%), vs.12(22.2%), P=0.02]. Two hundred seventy-two IVF cycles were analyzed according to inclusion criteria [ANT-N = 146 (53.7%); FL-N = 126 (46.3%)] and 85.7% of the cycles went to ET (ANT = 89.7 and FL = 81.0%). Respective demographic characteristics including mean age, BMI, number of prior superovulation/intrauterine inseminations, gravidity, and parity were similar between both groups. The AFC was higher (7.06 ± 2.36 vs. 8.87 ± 3.15, P<0.0001) and day 3 FSH level lower (10.40 ± 3.80 vs. 8.17 ± 2.32, P<0.0001) in the ANT group. After controlling for day 3 AFC and FSH, the ANT group demonstrated a greater ovarian response and produced higher quality embryos compared to FL group. The overall clinical pregnancy and live birth rates in both groups were similar but subanalysis of the patients younger than 36 years old revealed that cycles of ANT group were more likely to result in live birth than the FL group [23 (42.6%), vs.12(22.2%), P=0.02]. ConclusionWhen controlling for ovarian reserve testing in women of favorable age prognosis groups, a specific subgroup of women < 36 years of age with anticipated low responder status demonstrated superior ovarian response, embryo cohort quality and pregnancy outcomes with ANT protocol compared to FL during first fresh IVF attempt. When controlling for ovarian reserve testing in women of favorable age prognosis groups, a specific subgroup of women < 36 years of age with anticipated low responder status demonstrated superior ovarian response, embryo cohort quality and pregnancy outcomes with ANT protocol compared to FL during first fresh IVF attempt." @default.
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• W2015013605 title "IVF outcomes following GnRH agonist flare and GnRH Antagonist stimulation protocols in young low responders undergoing their first IVF cycle" @default.
• W2015013605 doi "https://doi.org/10.1016/j.fertnstert.2011.07.1005" @default.
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