Assuntos
Fertilização in vitro/métodos , Técnicas de Maturação in Vitro de Oócitos/métodos , Injeções de Esperma Intracitoplásmicas/métodos , Teratozoospermia/complicações , Adulto , Feminino , Humanos , Técnicas de Maturação in Vitro de Oócitos/legislação & jurisprudência , Infertilidade Masculina/etiologia , MasculinoRESUMO
BACKGROUND: The aim of this study was to compare pregnancy rates and stimulation parameters in patients with diminished ovarian reserve, who were treated with recombinant human luteinizing hormone (r-LH) or menopausal gonadotropins (hMG), as part of a microdose flare protocol. METHODS: A retrospective cohort study was performed. Comparisons between the group that was stimulated with r-LH plus follicle stimulating hormone (FSH) to those treated with hMG and FSH, were performed. Measurements included: medication doses, number of oocyte collected, number of embryos obtained, pregnancy and clinical pregnancy rates. RESULTS: Patients in the r-LH group (N.=40) had significant higher clinical pregnancy rates (33% vs. 14%; P=0.04) and used lower dose of LH (1938 IU vs. 2807 IU; P=0.02) compared to patients that were stimulated with hMG (N.=39). CONCLUSIONS: r-LH may offer advantages for the treatment of diminished ovarian reserve when performing a microdose flare protocol when compared to hMG. Both larger and prospective studies should be carried out to confirm these findings.
Assuntos
Fertilização in vitro/métodos , Hormônio Foliculoestimulante/uso terapêutico , Hormônio Luteinizante/uso terapêutico , Menotropinas/uso terapêutico , Adulto , Estudos de Coortes , Feminino , Fármacos para a Fertilidade Feminina/administração & dosagem , Fármacos para a Fertilidade Feminina/uso terapêutico , Hormônio Foliculoestimulante/administração & dosagem , Humanos , Hormônio Luteinizante/administração & dosagem , Menotropinas/administração & dosagem , Reserva Ovariana/efeitos dos fármacos , Indução da Ovulação/métodos , Projetos Piloto , Gravidez , Taxa de Gravidez , Estudos RetrospectivosRESUMO
The aim of this retrospective study was to compare the oocyte yield with the luteal estradiol patch (LPA) - GnRH antagonist and microdose (MD) flare-up protocols in anticipated poor responders. Fifty-seven women who underwent IVF treatment following stimulation with LPA or MD protocols at McGill Reproductive Centre were matched for age and markers of ovarian reserve. Numbers of oocytes collected (6 vs 7), mature oocytes collected (5 vs 5), and oocyte maturation rates (72% vs 74%) were similar. The numbers of good quality embryos available (2 vs 1) and embryos transferred (3 vs 3) were likewise similar. Embryo implantation rate of 16.7% and clinical pregnancy rate of 38.9% achieved in the LPA group were almost 50% higher than the corresponding figures at 10.3% and 22.2% in the MD group; however, the differences were not statistically significant (p > 0.05 for all comparisons). Although the results do not suggest an increased oocyte yield or follicular synchronization with the LPA protocol, the observed trend toward higher embryo implantation and clinical pregnancy rates requires further research.
Assuntos
Estradiol/administração & dosagem , Fertilização in vitro , Hormônio Liberador de Gonadotropina/administração & dosagem , Infertilidade Feminina , Indução da Ovulação , Administração Cutânea , Adulto , Feminino , Hormônio Liberador de Gonadotropina/análogos & derivados , Hormônio Liberador de Gonadotropina/antagonistas & inibidores , Humanos , Fase Luteal/fisiologia , Recuperação de Oócitos , Gravidez , Resultado da Gravidez , Quebeque , Estudos RetrospectivosRESUMO
The proportions of good, fair, and poor embryos in 13 women with bilateral endometriomas were compared with those of 39 women without endometriomas and were found to be similar (47.2% vs. 41.1%, 28.3% vs. 32.8%, and 24.3% vs. 26.0%, respectively). Therefore, it appears that the presence of bilateral endometriomas during IVF treatment is not associated with reduced embryo quality.
