Kathryn L Shaia1, Kelly S Acharya1, Benjamin S Harris1, Jeremy M Weber2, Tracy Truong2, Suheil J Muasher3. 1. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina. 2. Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina. 3. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina. Electronic address: muashersj@gmail.com.
Abstract
OBJECTIVE: Oocyte donation has optimized our understanding of ovarian stimulation. Increasing the follicle-stimulating hormone (FSH) dose has been shown to adversely affect live birth rates in autologous cycles. Our objective is to assess whether this relationship holds true within the donor/recipient population. DESIGN: Retrospective cohort study. SETTING: Not applicable. PATIENTS: Data from 2014-2016 included 8,627 fresh donor cycles. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Live birth, clinical pregnancy, and miscarriage rates. RESULTS: The mean donor age ± standard deviation (SD) was 25.8 ± 2.8 years. Donors underwent a median of 16 days (interquartile range [IQR] 12, 19) of stimulation with a median (IQR) total FSH dose and daily dose of 2,350.0 (1,800.0, 3,025.0) and 153.8 (113.2, 205.0) IU, respectively. The live birth rate was 56.7% per transfer. For every 500-unit increase in FSH dose, there was a 3% reduction in the odds of a live birth (odds ratio [OR] 0.97; 95% confidence interval 0.95, 0.99), and a 3% reduction in the odds of a clinical pregnancy (OR 0.97; 95% confidence interval 0.95, 0.99). Days of stimulation and average daily dose were not significantly associated with live birth or clinical pregnancy. No significant association was found between miscarriage rates and total FSH dose, days of stimulation, or average daily dose. CONCLUSION: This is a novel report of a negative association of total FSH dosage on fresh IVF live births, performed in the donor population to control for oocyte source and endometrial receptivity.
OBJECTIVE: Oocyte donation has optimized our understanding of ovarian stimulation. Increasing the follicle-stimulating hormone (FSH) dose has been shown to adversely affect live birth rates in autologous cycles. Our objective is to assess whether this relationship holds true within the donor/recipient population. DESIGN: Retrospective cohort study. SETTING: Not applicable. PATIENTS: Data from 2014-2016 included 8,627 fresh donor cycles. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Live birth, clinical pregnancy, and miscarriage rates. RESULTS: The mean donor age ± standard deviation (SD) was 25.8 ± 2.8 years. Donors underwent a median of 16 days (interquartile range [IQR] 12, 19) of stimulation with a median (IQR) total FSH dose and daily dose of 2,350.0 (1,800.0, 3,025.0) and 153.8 (113.2, 205.0) IU, respectively. The live birth rate was 56.7% per transfer. For every 500-unit increase in FSH dose, there was a 3% reduction in the odds of a live birth (odds ratio [OR] 0.97; 95% confidence interval 0.95, 0.99), and a 3% reduction in the odds of a clinical pregnancy (OR 0.97; 95% confidence interval 0.95, 0.99). Days of stimulation and average daily dose were not significantly associated with live birth or clinical pregnancy. No significant association was found between miscarriage rates and total FSH dose, days of stimulation, or average daily dose. CONCLUSION: This is a novel report of a negative association of total FSH dosage on fresh IVF live births, performed in the donor population to control for oocyte source and endometrial receptivity.
Authors: Jennifer F Kawwass; Patrick Ten Eyck; Patrick Sieber; Heather S Hipp; Brad Van Voorhis Journal: J Assist Reprod Genet Date: 2021-04-01 Impact factor: 3.412