Li-Te Lin1,2,3, Salvatore Giovanni Vitale4,5, San-Nung Chen1, Zhi-Hong Wen6, Hsiao-Wen Tsai1,2, Chyi-Uei Chern1, Kuan-Hao Tsui7,8,9. 1. Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. 2. Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan. 3. Department of Nursing, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan. 4. Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy. vitalesalvatore@hotmail.com. 5. Unit of Gynaecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy. vitalesalvatore@hotmail.com. 6. Department of Marine Biotechnology and Resources, National Sun Yat-sen University, Kaohsiung, Taiwan. 7. Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. khtsui60@gmail.com. 8. Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan. khtsui60@gmail.com. 9. Department of Pharmacy and Master Program, College of Pharmacy and Health Care, Tajen University, Pingtung County, Taiwan. khtsui60@gmail.com.
Abstract
INTRODUCTION: Luteal phase ovarian stimulation (LPOS) has been proven a feasible protocol for infertile patients. High progesterone level in the luteal phase could physiologically inhibit premature luteinizing hormone surge, from which poor ovarian responders (PORs) could obtain benefits. Therefore, we aimed to compare clinical outcomes between LPOS and follicular phase ovarian stimulation (FPOS) protocol in PORs undergoing in vitro fertilization (IVF). METHODS: This prospective pilot study was performed at one tertiary center from January 2016 to October 2017. A total of 60 PORs who met Bologna criteria and undergoing IVF were enrolled. Thirty PORs were allocated to the LPOS group and 30 PORs were allocated to the FPOS group. Basic characteristics, cycle characteristics, and pregnancy outcomes were compared between the two groups. RESULTS: The length of stimulation was significantly longer in the LPOS group than in the FPOS group. The numbers of retrieved oocytes, metaphase II oocytes, fertilized oocytes, and day-3 embryos were significantly higher in the LPOS group than in the FPOS group. Conversely, we could not find any significant difference for clinical pregnancy rate, ongoing pregnancy rate, abortion rate, and cancellation rate. The multivariate analysis showed that only LPOS (p = 0.007) was significantly associated the possibility to retrieve three or more oocytes, whereas basal follicle-stimulating hormone (FSH) < 8 IU/l (p = 0.103) and antral follicle count (AFC) ≥ 3 (p = 0.143) did not significantly affect this event. CONCLUSION: LPOS allows improved oocyte retrieval and oocyte quality in PORs with respect to FPOS, despite comparable pregnancy outcomes. LPOS may be considered a feasible option for oocytes accumulation in PORs. TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT03238833.
INTRODUCTION: Luteal phase ovarian stimulation (LPOS) has been proven a feasible protocol for infertilepatients. High progesterone level in the luteal phase could physiologically inhibit premature luteinizing hormone surge, from which poor ovarian responders (PORs) could obtain benefits. Therefore, we aimed to compare clinical outcomes between LPOS and follicular phase ovarian stimulation (FPOS) protocol in PORs undergoing in vitro fertilization (IVF). METHODS: This prospective pilot study was performed at one tertiary center from January 2016 to October 2017. A total of 60 PORs who met Bologna criteria and undergoing IVF were enrolled. Thirty PORs were allocated to the LPOS group and 30 PORs were allocated to the FPOS group. Basic characteristics, cycle characteristics, and pregnancy outcomes were compared between the two groups. RESULTS: The length of stimulation was significantly longer in the LPOS group than in the FPOS group. The numbers of retrieved oocytes, metaphase II oocytes, fertilized oocytes, and day-3 embryos were significantly higher in the LPOS group than in the FPOS group. Conversely, we could not find any significant difference for clinical pregnancy rate, ongoing pregnancy rate, abortion rate, and cancellation rate. The multivariate analysis showed that only LPOS (p = 0.007) was significantly associated the possibility to retrieve three or more oocytes, whereas basal follicle-stimulating hormone (FSH) < 8 IU/l (p = 0.103) and antral follicle count (AFC) ≥ 3 (p = 0.143) did not significantly affect this event. CONCLUSION:LPOS allows improved oocyte retrieval and oocyte quality in PORs with respect to FPOS, despite comparable pregnancy outcomes. LPOS may be considered a feasible option for oocytes accumulation in PORs. TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT03238833.
Authors: Muhammad Fatum; Marie Eve Bergeron; Caroline Ross; Anni Ding; Ayesha Bhevan; Karen Turner; Tim Child Journal: Int J Fertil Steril Date: 2020-07-15
Authors: Gemma Biviá-Roig; Ruth Blasco-Sanz; Ana Boldó-Roda; M Dolores Vara; Tamara Escrivá-Martínez; Rocío Herrero; Valentina Lucia La Rosa; Rosa M Baños; Juan Francisco Lisón Journal: Int J Environ Res Public Health Date: 2020-11-10 Impact factor: 3.390