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- W2016095921 abstract "ObjectiveTo identify risk factors for breakthrough ovulation despite GnRH antagonist suppression in IVF cycles.DesignRetrospective Case Control.Materials and MethodsPatients with breakthrough ovulation as evidenced by rise in serum LH >15mIU/mL (at least 100% increase) associated with drop in E2 and cul-de-sac free fluid on ultrasound were identified following review of all cycles from 8/04-8/11. Patients were suppressed with 0.25mg Cetrotide or Ganirelix once the lead follicle reached 13mm or E2 surpassed 300pg/mL. Demographics for index patients (n=53) were compared against all antagonist cycles (n=10,810). As index patients were older than the general control group (40 vs. 38, p=0.0009), age-matched controls (allocation 1:50) were randomly selected to assess for additional risk factors. Statistical analyses via t-tests with p < 0.05 were considered significant.ResultsTabled 1IndexAge-Matched Controlp-valuen=532,650Age40.2±3.040.2±3.01BMI25.5±6.323.3 ± 6.70.016AFC5.1±2.97.0±3.50.0001Day 3 FSH11.2±6.25.3±3.70.0001Start Dose534.0±122.5454.2±148.40.0001Days of Antagonist4.2±1.73.9±1.70.26Total Gonadotropins5840.1±294.04134.8±2338.80.0001Days of Stimulation (up to surge or trigger)11.5±2.78.68±3.80.0001Values= Mean ± SD. Open table in a new tab ConclusionPatients with markedly diminished ovarian reserve are an at-risk group for breakthrough ovulation despite GnRH antagonist down-regulation. Further study is required to determine whether patients with markedly diminished reserve subjected to prolonged stimulation would benefit from more suppressive doses of GnRH antagonists. ObjectiveTo identify risk factors for breakthrough ovulation despite GnRH antagonist suppression in IVF cycles. To identify risk factors for breakthrough ovulation despite GnRH antagonist suppression in IVF cycles. DesignRetrospective Case Control. Retrospective Case Control. Materials and MethodsPatients with breakthrough ovulation as evidenced by rise in serum LH >15mIU/mL (at least 100% increase) associated with drop in E2 and cul-de-sac free fluid on ultrasound were identified following review of all cycles from 8/04-8/11. Patients were suppressed with 0.25mg Cetrotide or Ganirelix once the lead follicle reached 13mm or E2 surpassed 300pg/mL. Demographics for index patients (n=53) were compared against all antagonist cycles (n=10,810). As index patients were older than the general control group (40 vs. 38, p=0.0009), age-matched controls (allocation 1:50) were randomly selected to assess for additional risk factors. Statistical analyses via t-tests with p < 0.05 were considered significant. Patients with breakthrough ovulation as evidenced by rise in serum LH >15mIU/mL (at least 100% increase) associated with drop in E2 and cul-de-sac free fluid on ultrasound were identified following review of all cycles from 8/04-8/11. Patients were suppressed with 0.25mg Cetrotide or Ganirelix once the lead follicle reached 13mm or E2 surpassed 300pg/mL. Demographics for index patients (n=53) were compared against all antagonist cycles (n=10,810). As index patients were older than the general control group (40 vs. 38, p=0.0009), age-matched controls (allocation 1:50) were randomly selected to assess for additional risk factors. Statistical analyses via t-tests with p < 0.05 were considered significant. ResultsTabled 1IndexAge-Matched Controlp-valuen=532,650Age40.2±3.040.2±3.01BMI25.5±6.323.3 ± 6.70.016AFC5.1±2.97.0±3.50.0001Day 3 FSH11.2±6.25.3±3.70.0001Start Dose534.0±122.5454.2±148.40.0001Days of Antagonist4.2±1.73.9±1.70.26Total Gonadotropins5840.1±294.04134.8±2338.80.0001Days of Stimulation (up to surge or trigger)11.5±2.78.68±3.80.0001Values= Mean ± SD. Open table in a new tab Values= Mean ± SD. ConclusionPatients with markedly diminished ovarian reserve are an at-risk group for breakthrough ovulation despite GnRH antagonist down-regulation. Further study is required to determine whether patients with markedly diminished reserve subjected to prolonged stimulation would benefit from more suppressive doses of GnRH antagonists. Patients with markedly diminished ovarian reserve are an at-risk group for breakthrough ovulation despite GnRH antagonist down-regulation. Further study is required to determine whether patients with markedly diminished reserve subjected to prolonged stimulation would benefit from more suppressive doses of GnRH antagonists." @default.
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- W2016095921 title "Identifiable risk factors for breakthrough ovulation despite GnRH antagonist suppression in IVF cycles" @default.
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