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• W2045459405 abstract "ObjectiveTo test the hypothesis that synchronizing initiation of ovarian stimulation with follicle wave emergence would optimize IVF/intracytoplasmic sperm injection (ICSI) outcomes in patients with a prior suboptimal response.DesignProspective, randomized, controlled trial.SettingAcademic and private reproductive endocrinology and infertility centers.Patient(s)Eighty women ≤43 years of age with a history of a suboptimal response.Intervention(s)Initiation of recombinant FSH/GnRH antagonist/recombinant LH/hCG on day 1 (n = 39) or day 4 (n = 41).Main Outcome Measure(s)Numbers of clinical and biochemical pregnancies, follicles ≥10 and ≥15 mm, oocytes collected, fertilized oocytes, cleavage stage embryos, and blastocysts; serum E2 concentrations. Outcomes were compared between treatment groups.Result(s)The numbers of follicles that developed to ≥10 and ≥15 mm and serum E2 were greater when recombinant FSH was initiated on day 1 (5.4, 4.3, 5,827.2 pmol/L) versus day 4 (3.6, 2.5, 4,230.1 pmol/L). The numbers of collected, metaphase II, and fertilized oocytes; cleavage stage embryos; and blastocysts were not different between groups. When we evaluated only those cycles that proceeded to oocyte pick-up, a lower implantation rate (16.1%, 56.0%), biochemical pregnancy rate (PR) (16.1%, 48.0%), and clinical PR (12.9% vs. 36.0%) were detected in the day 1 group versus day 4 group.Conclusion(s)Synchronizing initiation of ovarian stimulation with follicle wave emergence in patients with a prior suboptimal response resulted in an increase in the number of dominant follicles and serum E2 concentrations; however, improvements in oocyte, embryo, or pregnancy outcomes did not occur.Clinical Trial Registration NumberNCT00439829. To test the hypothesis that synchronizing initiation of ovarian stimulation with follicle wave emergence would optimize IVF/intracytoplasmic sperm injection (ICSI) outcomes in patients with a prior suboptimal response. Prospective, randomized, controlled trial. Academic and private reproductive endocrinology and infertility centers. Eighty women ≤43 years of age with a history of a suboptimal response. Initiation of recombinant FSH/GnRH antagonist/recombinant LH/hCG on day 1 (n = 39) or day 4 (n = 41). Numbers of clinical and biochemical pregnancies, follicles ≥10 and ≥15 mm, oocytes collected, fertilized oocytes, cleavage stage embryos, and blastocysts; serum E2 concentrations. Outcomes were compared between treatment groups. The numbers of follicles that developed to ≥10 and ≥15 mm and serum E2 were greater when recombinant FSH was initiated on day 1 (5.4, 4.3, 5,827.2 pmol/L) versus day 4 (3.6, 2.5, 4,230.1 pmol/L). The numbers of collected, metaphase II, and fertilized oocytes; cleavage stage embryos; and blastocysts were not different between groups. When we evaluated only those cycles that proceeded to oocyte pick-up, a lower implantation rate (16.1%, 56.0%), biochemical pregnancy rate (PR) (16.1%, 48.0%), and clinical PR (12.9% vs. 36.0%) were detected in the day 1 group versus day 4 group. Synchronizing initiation of ovarian stimulation with follicle wave emergence in patients with a prior suboptimal response resulted in an increase in the number of dominant follicles and serum E2 concentrations; however, improvements in oocyte, embryo, or pregnancy outcomes did not occur." @default.
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• W2045459405 date "2012-10-01" @default.
• W2045459405 modified "2023-09-30" @default.
• W2045459405 title "Synchronization of ovarian stimulation with follicle wave emergence in patients undergoing in vitro fertilization with a prior suboptimal response: a randomized, controlled trial" @default.
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• W2045459405 doi "https://doi.org/10.1016/j.fertnstert.2012.06.051" @default.
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