Joaquin Errázuriz1, Panagiotis Drakopoulos2, David Pening3, Annalisa Racca4, Alessia Romito5, Nelke De Munck6, Herman Tournaye6, Michel De Vos6, Christophe Blockeel7. 1. Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium; Departamento de Ginecología y Obstetricia, Facultad de Medicina, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile. 2. Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium; Vrije Universiteit Brussel, Faculty of Medicine and Pharmacy, Department of Surgical and Clinical Science, Belgium. 3. Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium; Université Libre de Bruxelles, Brussels, Belgium. 4. Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium; University of Genoa, Academic Unit of Obstetrics and Gynecology, IRCCS AOU San Martino, Italy. 5. Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium; University of Sapienza, Obstetrics and Gynecology Department, Rome, Italy. 6. Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium. 7. Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium; University of Zagreb-School of Medicine, Department of Obstetrics and Gynecology Zagreb, Croatia. Electronic address: christophe.blockeel@uzbrussel.be.
Abstract
RESEARCH QUESTION: Does the type of pituitary suppression protocol influence cumulative live birth rate (LBR) in Bologna poor responders treated with corifollitropin alfa (CFA)? DESIGN: Retrospective cohort analysis including poor responder patients fulfilling the Bologna criteria who underwent their first intracytoplasmic sperm injection cycle using a CFA-based ovarian stimulation protocol between 2011 and 2017. The starting dose of CFA was 150 µg. The primary outcome was cumulative LBR, defined as the first delivery of a live born resulting from the fresh and all the subsequent frozen embryo transfers. RESULTS: A total of 717 cycles were divided into three groups: A (gonadotrophin-releasing hormone [GnRH] antagonist protocol, n = 407), B (long GnRH agonist protocol, n = 224) and C (short GnRH agonist protocol, n = 86). Cumulative LBR did not significantly differ between groups (20.1% versus 17.4% versus 14.0%; P = 0.35). Significantly more patients in Group A had supernumerary embryos cryopreserved (28.3% versus 18.4% versus 11.6%; P < 0.001). Days of additional highly purified human menopausal gonadotrophin 300 IU injections following CFA were significantly different between Groups A, B and C (3 versus 5 versus 3 days; P < 0.001). Multivariate logistic regression analysis showed that the number of oocytes retrieved remained an independent predictive factor (odds ratio 1.23, 95% confidence interval 1.16-1.31) for cumulative LBR. CONCLUSIONS: Poor responders according to the Bologna criteria in whom CFA is used for ovarian stimulation had comparable cumulative LBR, irrespective of the type of pituitary suppression. An increase in number of oocytes retrieved is an independent variable related to cumulative LBR.
RESEARCH QUESTION: Does the type of pituitary suppression protocol influence cumulative live birth rate (LBR) in Bologna poor responders treated with corifollitropin alfa (CFA)? DESIGN: Retrospective cohort analysis including poor responder patients fulfilling the Bologna criteria who underwent their first intracytoplasmic sperm injection cycle using a CFA-based ovarian stimulation protocol between 2011 and 2017. The starting dose of CFA was 150 µg. The primary outcome was cumulative LBR, defined as the first delivery of a live born resulting from the fresh and all the subsequent frozen embryo transfers. RESULTS: A total of 717 cycles were divided into three groups: A (gonadotrophin-releasing hormone [GnRH] antagonist protocol, n = 407), B (long GnRH agonist protocol, n = 224) and C (short GnRH agonist protocol, n = 86). Cumulative LBR did not significantly differ between groups (20.1% versus 17.4% versus 14.0%; P = 0.35). Significantly more patients in Group A had supernumerary embryos cryopreserved (28.3% versus 18.4% versus 11.6%; P < 0.001). Days of additional highly purified human menopausal gonadotrophin 300 IU injections following CFA were significantly different between Groups A, B and C (3 versus 5 versus 3 days; P < 0.001). Multivariate logistic regression analysis showed that the number of oocytes retrieved remained an independent predictive factor (odds ratio 1.23, 95% confidence interval 1.16-1.31) for cumulative LBR. CONCLUSIONS: Poor responders according to the Bologna criteria in whom CFA is used for ovarian stimulation had comparable cumulative LBR, irrespective of the type of pituitary suppression. An increase in number of oocytes retrieved is an independent variable related to cumulative LBR.
Authors: F M Fusi; L Zanga; M Arnoldi; S Melis; M Cappato; I Candeloro; A Di Pasqua Journal: Reprod Biol Endocrinol Date: 2020-07-09 Impact factor: 5.211
Authors: Alessia Romito; Erlisa Bardhi; Joaquin Errazuriz; Christophe Blockeel; Samuel Santos-Ribeiro; Michel De Vos; Annalisa Racca; Shari Mackens; Annelore Van Der Kelen; Pierluigi Benedetti Panici; Alberto Vaiarelli; Herman Tournaye; Panagiotis Drakopoulos Journal: Front Endocrinol (Lausanne) Date: 2020-04-16 Impact factor: 5.555