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• W4387395924 abstract "Evaluate the effectiveness of using continuous clomiphene citrate (CC) as an alternative to gonadotropin hormone-releasing hormone (GnRH) antagonist during controlled ovarian hyperstimulation for patients undergoing in-vitro fertilization (IVF). A retrospective, cross-sectional study identified individuals aged 18-50 undergoing their first cycle of autologous IVF at a single fertility clinic from 2015-2021 utilizing a continuous CC protocol of 100mg daily from start of gonadotropins until day of ovulation trigger. All embryos were cultured to the blastocyst stage and vitrified prior to thaw and embryo transfer. The primary outcome was prevalence of elevated luteinizing hormone (LH) levels prior to ovulation trigger (defined as >15ng/ml). Secondary outcomes included cycle cancellations, addition of a GnRH antagonist, number of oocytes retrieved, number of embryos grade 4BB or better, and live birth rates. Descriptive statistics were used for primary data analysis. The study wasgrantedinstitutional review board exemption. This study evaluatedn=877 planned IVF cycles used a continuous CC protocol; LH peak prior to ovulation trigger had a mean ofM=10 ng/mL. Eleven percent (n=99) of cycles were complicated by premature LH >15 ng/mL. Ninety percent (n=793) of cycles were completed, and cancellations occurred in 9.6% of cycles (n=84). Premature LH surge occurred in 9.5% of cancelled cycles (n=8). GnRH antagonists were used to rescue 0.5% (n=5) cycles. Mean oocytes retrieved wasM=14.33 (SD=9.07) in all cycles and M=15.21 (SD=10.78) in premature LH rise cycles. In all cycles, a mean ofM=3.81 (SD=3.61) 4BB or better embryos were created andM=3.63 (SD=3.63) in cycles with a LH peak > 15 ng/mL. Two cycles were complicated by retrieval of no oocytes; neither cycle had evidence of premature LH rise. Continuous CC protocol demonstrated a cumulative live birth rate of 49.5% (n=447) with 34.4% (n=311) of live births resulting from the first embryo transfer. Prevalence of premature LH rise with continuous CC was 11%, which is higher than the historically reported 8% seen with GnRH antagonists and 9% reported in smaller studies of CC protocols. Cycle cancellations due to premature LH surge remained rare. Cumulative live birth rates of 49.5% noted in this study are higher than literature reported rates of 25-33% with GnRH antagonists. Due to reduced costs, oral route of administration, and good clinical outcomes, continuous CC could be considered an alternative to GnRH antagonists to prevent premature LH surge in freeze-all IVF cycles. Further prospective studies are warranted to directly compare these methods." @default.
• W4387395924 created "2023-10-07" @default.
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• W4387395924 date "2023-10-01" @default.
• W4387395924 modified "2023-10-07" @default.
• W4387395924 title "CONTINUOUS CLOMIPHENE RELIABLY BLOCKS LUTEINIZING HORMONE SURGE IN PATIENTS UNDERGOING IN VITRO FERTILIZATION: A RETROSPECTIVE, CROSS-SECTIONAL STUDY" @default.
• W4387395924 doi "https://doi.org/10.1016/j.fertnstert.2023.08.860" @default.
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