Andrea Reh1, Lewis Krey, Nicole Noyes. 1. New York University Fertility Center, New York University School of Medicine, New York, New York, USA.
Abstract
OBJECTIVE: To explore the long- and short-term trends in LH-suppression protocol use and patient profile characteristics. DESIGN: Descriptive study, retrospective cohort. SETTING: Large, university-based IVF center. PATIENT(S): Four thousand five hundred one fresh IVF cycles categorized by use of GnRH antagonist, luteal GnRH agonist, and follicular microdose GnRH agonist. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Frequency of use of LH-suppression protocol, patient and cycle characteristics, and outcomes at 10-year (1996-2005), 5-year (2001-5), and 3-year intervals (2004-6). RESULT(S): In both the <40 and >or=40 age groups, GnRH antagonist use increased from 2001 to 2005, while luteal GnRH agonist and microdose use decreased. The most recent luteal agonist patients were better responders and had higher implantation, clinical pregnancy, and delivery rates. Antagonist patients in the <40 and >or=40 age groups had a better response in 2005 than in 2001 with higher clinical pregnancy rates. Microdose patients responded worse in 2005 than in 2001, although pregnancy rates did not change significantly. Such trends were echoed from 2004 to 2006. CONCLUSION(S): The target population for GnRH antagonist has broadened to include younger, normal responders in addition to the traditional poor responder. Luteal agonist and microdose protocols are chosen less frequently and remain targeted toward good and poor responders, respectively. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
OBJECTIVE: To explore the long- and short-term trends in LH-suppression protocol use and patient profile characteristics. DESIGN: Descriptive study, retrospective cohort. SETTING: Large, university-based IVF center. PATIENT(S): Four thousand five hundred one fresh IVF cycles categorized by use of GnRH antagonist, luteal GnRH agonist, and follicular microdose GnRH agonist. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Frequency of use of LH-suppression protocol, patient and cycle characteristics, and outcomes at 10-year (1996-2005), 5-year (2001-5), and 3-year intervals (2004-6). RESULT(S): In both the <40 and >or=40 age groups, GnRH antagonist use increased from 2001 to 2005, while luteal GnRH agonist and microdose use decreased. The most recent luteal agonist patients were better responders and had higher implantation, clinical pregnancy, and delivery rates. Antagonist patients in the <40 and >or=40 age groups had a better response in 2005 than in 2001 with higher clinical pregnancy rates. Microdose patients responded worse in 2005 than in 2001, although pregnancy rates did not change significantly. Such trends were echoed from 2004 to 2006. CONCLUSION(S): The target population for GnRH antagonist has broadened to include younger, normal responders in addition to the traditional poor responder. Luteal agonist and microdose protocols are chosen less frequently and remain targeted toward good and poor responders, respectively. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Authors: Andrea Reh; Sonal Chaudhry; Felicia Mendelsohn; Shelly Im; Linda Rolnitzky; Alana Amarosa; Mortimer Levitz; Suman Srinivasa; Lewis Krey; Alan S Berkeley; James A Grifo; Ann Danoff Journal: Fertil Steril Date: 2010-11-03 Impact factor: 7.329