Literature DB >> 29699137

Using a mild stimulation protocol combined with clomiphene citrate and recombinant follicle-stimulating hormone to determine the optimal number of oocytes needed to achieve pregnancy and reduce the concerns of patients.

Rikikazu Sugiyama1, Koji Nakagawa1, Yayoi Nishi1, Yuko Ojiro1, Hiroyasu Juen1, Rie Sugiyama2, Yasushi Kuribayashi2.   

Abstract

PURPOSE: The purpose of this study was to investigate how many oocytes are needed to achieve an adequate pregnancy rate per 1 oocyte retrieval cycle in mild ovarian stimulation.
METHODS: This protocol consisted of clomiphene citrate and recombinant-follicle-stimulating hormone injection without a gonadotropin-releasing hormone-antagonist. From January 2009 through December 2010, there were 1,227 women who underwent assisted reproductive technologies treatment with mild stimulation at the Sugiyama Clinic. The overall pregnancy rate per single oocyte retrieval cycle was evaluated using both fresh and cryopreserved-and-thawed embryos according to the retrieved oocyte number.
RESULTS: According to the retrieved oocyte number, a total of 1,227 cycles were divided into 4 groups: group A (the oocyte number <4; 433 cycles), group B (the oocyte number = 4, 5; 317 cycles), group C (the oocyte number = 6, 7; 206 cycles), and group D (the oocyte number ≥8; 271 cycles). The overall pregnancy rates for groups A, B, C, and D were 22.2, 42.9, 52.4, and 56.0 %, respectively, the rates for groups C and D were significantly higher than that for group A (p < 0.01).
CONCLUSIONS: The optimal number of retrieved oocytes proved to be between 6 and 7 for the patients who received our milder stimulation protocol and experienced no reduction in their overall pregnancy rate.

Entities:  

Keywords:  Clomiphene citrate; Mild stimulation; Optimal oocyte number; Overall pregnancy rate; Rec‐FSH

Year:  2013        PMID: 29699137      PMCID: PMC5907126          DOI: 10.1007/s12522-013-0148-y

Source DB:  PubMed          Journal:  Reprod Med Biol        ISSN: 1445-5781


  16 in total

Review 1.  The science behind 25 years of ovarian stimulation for in vitro fertilization.

Authors:  Nick S Macklon; Richard L Stouffer; Linda C Giudice; Bart C J M Fauser
Journal:  Endocr Rev       Date:  2006-01-24       Impact factor: 19.871

2.  Milder ovarian stimulation for in-vitro fertilization reduces aneuploidy in the human preimplantation embryo: a randomized controlled trial.

Authors:  Esther B Baart; Elena Martini; Marinus J Eijkemans; Diane Van Opstal; Nicole G M Beckers; Arie Verhoeff; Nicolas S Macklon; Bart C J M Fauser
Journal:  Hum Reprod       Date:  2007-01-04       Impact factor: 6.918

Review 3.  The clinical significance of the retrieval of a low number of oocytes following mild ovarian stimulation for IVF: a meta-analysis.

Authors:  M F G Verberg; M J C Eijkemans; N S Macklon; E M E W Heijnen; E B Baart; F P Hohmann; B C J M Fauser; F J Broekmans
Journal:  Hum Reprod Update       Date:  2009 Jan-Feb       Impact factor: 15.610

4.  Less is more: increased gonadotropin use for ovarian stimulation adversely influences clinical pregnancy and live birth after in vitro fertilization.

Authors:  Lubna Pal; Sangita Jindal; Barry R Witt; Nanette Santoro
Journal:  Fertil Steril       Date:  2008-04-28       Impact factor: 7.329

5.  Minimal ovarian hyperstimulation for in vitro fertilization using sequential clomiphene citrate and gonadotropin with or without the addition of a gonadotropin-releasing hormone antagonist.

Authors:  Shaun C Williams; William E Gibbons; Suheil J Muasher; Sergio Oehninger
Journal:  Fertil Steril       Date:  2002-11       Impact factor: 7.329

Review 6.  Mild/minimal stimulation for in vitro fertilization: an old idea that needs to be revisited.

Authors:  Shvetha M Zarek; Suheil J Muasher
Journal:  Fertil Steril       Date:  2011-05-07       Impact factor: 7.329

7.  Hyaluronan-enriched transfer medium improves outcome in patients with multiple embryo transfer failures.

Authors:  Koji Nakagawa; Chie Takahashi; Yayoi Nishi; Hiroyasu Jyuen; Rie Sugiyama; Yasushi Kuribayashi; Rikikazu Sugiyama
Journal:  J Assist Reprod Genet       Date:  2012-04-12       Impact factor: 3.412

8.  Elective single cleavage-stage embryo transfer need not result in lower pregnancy rates compared to double cleavage-stage embryo transfer.

Authors:  Koji Nakagawa; Yayoi Nishi; Rie Sugiyama; Yasushi Kuribayashi; Rikikazu Sugiyama; Masato Inoue
Journal:  J Obstet Gynaecol Res       Date:  2010-08       Impact factor: 1.730

9.  Vitrification of human embryos based on the assessment of suitable conditions for 8-cell mouse embryos.

Authors:  T Mukaida; S Wada; K Takahashi; P B Pedro; T Z An; M Kasai
Journal:  Hum Reprod       Date:  1998-10       Impact factor: 6.918

10.  The dilemma faced by patients who undergo single embryo transfer.

Authors:  Rikikazu Sugiyama; Koji Nakagawa; Yayoi Nishi; Rie Sugiyama; Kei Ezaki; Masato Inoue
Journal:  Reprod Med Biol       Date:  2008-12-26
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