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• W2890763718 abstract "To determine if different gonadotrophins and long agonist versus short antagonist stimulation protocols have an influence on embryo development, morphokinetic changes or outcome in older women. A single-centre observational study of women aged 38-45 years was conducted in Denmark. The women had regular cycles, a BMI <35 and a FSH level <13 at the initial fertility investigation. The women were pseudo randomised (by odd/even week number) to HP-hMG (Menopur; 225 - 300 IU; max 450 IU daily) or HP-hMG 150 IU in combination with uFSH (Bravelle; 150 - 225 IU; max 450 IU daily) and stimulated using a GnRH-agonist or GnRH-antagonist protocol according to standard practice at the centre. Data was collected from 441 stimulation cycles and 128 subsequent frozen transfers in 247 subjects. After oocyte aspiration and fertilisation (IVF or ICSI) all embryos were placed in 12 well slides in an EmbryoScope time-lapse system. Images of the embryos were acquired every 20 minutes, on 7 focus planes with a Z-stack of 15mm for up to 44h after fertilisation. At 44 hours embryo development was evaluated according to several morphological criteria. Embryos with supposed best potential, according to predefined parameters, were transferred (1-2 embryos in women <40 years, up to three embryos in women >40 years). Spare embryos with good morphology were frozen for future transfer. Implantation, ongoing pregnancy at 7 weeks and live birth were collected following embryo transfer. The treatment and COH protocol had no effect on the morphokinetic characteristics of the embryos. There were no significant differences in outcome measures between subjects using the combination and subjects using HP-hMG alone as part of an agonist or antagonist protocol. There were no apparent differences in outcome measures between the COH protocols. As expected, patient age had an effect on the number of retrieved, fertilised and cleaved oocytes. However, the proportion of cycles that yielded one or more top quality pre-embryos was similar for all age groups. The negative influence of age on implantation, clinical pregnancy and live births was evident in the oldest age group (43-45 years) but results in the 40-42 year age group were similar to those obtained in the 38-39 year age group. Gonadotrophin treatment, COH protocol or age had no effect on the morphokinetics of the retrieved oocytes. Using the HP-hMG/uFSH combination did not significantly improve outcome measures compared to using HP-hMG alone.Tabled 1Agonist protocolAntagonist protocolHP-hMGHP-hMG/uFSHHP-hMGHP-hMG/uFSHn%n%n%n%Implanted embryos011676.86672.512674.64167.213120.52426.44124.31829.5242.611.121.223.3Ongoing pregnancy012280.86975.813579.94268.912516.62224.23218.91931.1242.6--21.2--Live birth013488.78189.014485.24573.811610.61011.02414.21626.2210.7--10.6-- Open table in a new tab" @default.
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• W2890763718 date "2018-09-01" @default.
• W2890763718 modified "2023-10-14" @default.
• W2890763718 title "Do combined gonadotrophin protocols improve embryo morphology or outcome in older women?" @default.
• W2890763718 doi "https://doi.org/10.1016/j.fertnstert.2018.07.575" @default.
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