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• W3180804556 abstract "BackgroundWhile many studies have been done comparing the clinical outcomes of various gonadotropic stimulation protocols [1], none have been done studying the optimal stimulation regimen depending on a patient’s characteristics. Age, BMI and AMH can affect clinical pregnancy rates [2,3]. The present study was designed to analyze how these variables can affect the relationships between stimulation protocols and treatment outcomes.ObjectiveThe objective was to determine the ideal ovarian stimulation protocol depending on a patient’s age, BMI, and AMH.MATERIAL AND METHODS: We analyzed a total of 2369 Assisted Reproductive Technology cycles for patients who underwent In vitro fertilization at Fertility Centers of Illinois from 2017 to 2019. Patient’s age, BMI, and AMH levels were determined before the start of treatment. Four different protocols were used and patients were assigned to a particular protocol per physician preference. The breakdown was as follows: Ganirelix acetate (n=1648), Leuprolide acetate (n=461), Leuprolide acetate Stop (n=6), Leuprolide acetate Microdose (n=254). Inclusion criteria was diagnosis of infertility, undergoing fresh IVF cycle, and completed medical record. Freeze all cycles for any indication were excluded. Primary outcome was clinical pregnancy rates. The ranges of Age, BMI and AMH levels from lowest to highest were determined. They were as follows: Age (22-49), BMI (13.7-49.7) and AMH (0.015-46.7). The ranges (R) for Age, BMI, and AMH were then individually divided into four different quartile (Q) distributions (0-25th, 26-50th, 51-75th, and 76-100th) each. With four quartiles given for each of the three patient factors, patients were classified into one of sixty-four (4ˆ3) unique age/BMI/Age combinations. The protocol with the highest clinical pregnancy rate was determined for each of the sixty-four different stratifications. Statistical analysis was performed using SPSS. The data was analyzed using Chi square test and Fisher’s Exact Test. A P value of <0.05 was considered statistically significant.ResultsLeuprolide acetate had the highest pregnancy rate in 35/64 (54%) of the stratifications, followed by Ganirelix acetate 17/64 (26%), Leuprolide acetate Microdose 16/64 (25%) and Leuprolide acetate Stop 1/64 (1.5%). Leuprolide acetate was significantly better than all other protocols in five different stratifications listed in Table 1. Leuprolide acetate Microdose, Leuprolide acetate Stop and Ganirelix acetate were not significantly better than all other protocols in any stratification.ConclusionMany studies have been done comparing the clinical outcomes of variousgonadotropic stimulation protocols. Leuprolide acetate had a significantly higher clinical pregnancy rate than Ganirelix acetate for at least five stratifications listed above. Studies with a greater number of patients are required to establish frameworks regarding the optimal protocols for a specific age, BMI and AMH levels.Financial SupportNoneReferences:1. Muasher SJ, et,.Optimal stimulation protocols for in vitro fertilization. Fertil Steril. 2006 Aug;86(2):267-73.2. Loutradis D, et al,.A. Different ovarian stimulation protocols for women with diminished ovarian reserve. J Assist Reprod Genet. 2007;24(12):597-611.3. Supramaniam PR, et al,.The correlation between raised body mass index and assisted reproductive treatment outcomes: a systematic review and meta-analysis of the evidence. Reprod Health. 2018 Feb 27;15(1):34 BackgroundWhile many studies have been done comparing the clinical outcomes of various gonadotropic stimulation protocols [1], none have been done studying the optimal stimulation regimen depending on a patient’s characteristics. Age, BMI and AMH can affect clinical pregnancy rates [2,3]. The present study was designed to analyze how these variables can affect the relationships between stimulation protocols and treatment outcomes. While many studies have been done comparing the clinical outcomes of various gonadotropic stimulation protocols [1], none have been done studying the optimal stimulation regimen depending on a patient’s characteristics. Age, BMI and AMH can affect clinical pregnancy rates [2,3]. The present study was designed to analyze how these variables can affect the relationships between stimulation protocols and treatment outcomes. ObjectiveThe objective was to determine the ideal ovarian stimulation protocol depending on a patient’s age, BMI, and AMH.MATERIAL AND METHODS: We analyzed a total of 2369 Assisted Reproductive Technology cycles for patients who underwent In vitro fertilization at Fertility Centers of Illinois from 2017 to 2019. Patient’s age, BMI, and AMH levels were determined before the start of treatment. Four different protocols were used and patients were assigned to a particular protocol per physician preference. The breakdown was as follows: Ganirelix acetate (n=1648), Leuprolide acetate (n=461), Leuprolide acetate Stop (n=6), Leuprolide acetate Microdose (n=254). Inclusion criteria was diagnosis of infertility, undergoing fresh IVF cycle, and completed medical record. Freeze all cycles for any indication were excluded. Primary outcome was clinical pregnancy rates. The ranges of Age, BMI and AMH levels from lowest to highest were determined. They were as follows: Age (22-49), BMI (13.7-49.7) and AMH (0.015-46.7). The ranges (R) for Age, BMI, and AMH were then individually divided into four different quartile (Q) distributions (0-25th, 26-50th, 51-75th, and 76-100th) each. With four quartiles given for each of the three patient factors, patients were classified into one of sixty-four (4ˆ3) unique age/BMI/Age combinations. The protocol with the highest clinical pregnancy rate was determined for each of the sixty-four different stratifications. Statistical analysis was performed using SPSS. The data was analyzed using Chi square test and Fisher’s Exact Test. A P value of <0.05 was considered statistically significant. The objective was to determine the ideal ovarian stimulation protocol depending on a patient’s age, BMI, and AMH. MATERIAL AND METHODS: We analyzed a total of 2369 Assisted Reproductive Technology cycles for patients who underwent In vitro fertilization at Fertility Centers of Illinois from 2017 to 2019. Patient’s age, BMI, and AMH levels were determined before the start of treatment. Four different protocols were used and patients were assigned to a particular protocol per physician preference. The breakdown was as follows: Ganirelix acetate (n=1648), Leuprolide acetate (n=461), Leuprolide acetate Stop (n=6), Leuprolide acetate Microdose (n=254). Inclusion criteria was diagnosis of infertility, undergoing fresh IVF cycle, and completed medical record. Freeze all cycles for any indication were excluded. Primary outcome was clinical pregnancy rates. The ranges of Age, BMI and AMH levels from lowest to highest were determined. They were as follows: Age (22-49), BMI (13.7-49.7) and AMH (0.015-46.7). The ranges (R) for Age, BMI, and AMH were then individually divided into four different quartile (Q) distributions (0-25th, 26-50th, 51-75th, and 76-100th) each. With four quartiles given for each of the three patient factors, patients were classified into one of sixty-four (4ˆ3) unique age/BMI/Age combinations. The protocol with the highest clinical pregnancy rate was determined for each of the sixty-four different stratifications. Statistical analysis was performed using SPSS. The data was analyzed using Chi square test and Fisher’s Exact Test. A P value of <0.05 was considered statistically significant. ResultsLeuprolide acetate had the highest pregnancy rate in 35/64 (54%) of the stratifications, followed by Ganirelix acetate 17/64 (26%), Leuprolide acetate Microdose 16/64 (25%) and Leuprolide acetate Stop 1/64 (1.5%). Leuprolide acetate was significantly better than all other protocols in five different stratifications listed in Table 1. Leuprolide acetate Microdose, Leuprolide acetate Stop and Ganirelix acetate were not significantly better than all other protocols in any stratification. Leuprolide acetate had the highest pregnancy rate in 35/64 (54%) of the stratifications, followed by Ganirelix acetate 17/64 (26%), Leuprolide acetate Microdose 16/64 (25%) and Leuprolide acetate Stop 1/64 (1.5%). Leuprolide acetate was significantly better than all other protocols in five different stratifications listed in Table 1. Leuprolide acetate Microdose, Leuprolide acetate Stop and Ganirelix acetate were not significantly better than all other protocols in any stratification. ConclusionMany studies have been done comparing the clinical outcomes of variousgonadotropic stimulation protocols. Leuprolide acetate had a significantly higher clinical pregnancy rate than Ganirelix acetate for at least five stratifications listed above. Studies with a greater number of patients are required to establish frameworks regarding the optimal protocols for a specific age, BMI and AMH levels. Many studies have been done comparing the clinical outcomes of various" @default.
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• W3180804556 title "OPTIMAL STIMULATION PROTOCOL FOR PATIENTS WITH OVULATORY DYSFUNCTION UNDERGOING FRESH VERSUS FROZEN EMBRYO TRANSFER" @default.
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