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Study of two strategies to induce follicular wave emergence for assisted reproductive treatments (ART)—a preliminary trial

  • Assisted Reproduction Technologies
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Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to induce follicular wave emergence (FWE) using pharmacological (recombinant hCG administration) or mechanical (aspiration of dominant follicle) interventions in infertile women.

Methods

Sixteen infertile women (≤35 years) with indications for in vitro fertilization due to tubal and/or male factor infertility were randomized into three groups: control (n = 6), pharmacological (n = 5) and mechanical (n = 5) groups. Women in both experimental groups underwent serial transvaginal sonograms (TVS) from menstrual cycle day 10 until identification of a dominant follicle ≥15 mm. Women in the pharmacological group received 250 μg of recombinant-hCG to induce ovulation, and resumed serial TVS 2 days later. In the mechanical group, dominant and subordinate follicles ≥10 mm were aspirated, and daily TVS was resumed on the following day. An increased pool of follicles ≥5 and ≤9 mm after interventions characterized FWE. Women in the control group underwent ovulation induction (OI) with 150 IU/day of recombinant follicle-stimulating hormone started on menstrual cycle day 3 (D3). OI was started on the day of FWE in the experimental groups. Endometrial asynchrony with development of the embryo was expected in the experimental groups. Therefore, all viable embryos were cryopreserved and transferred in an endometrial-stimulated cycle.

Results

The number of follicles ≥5 and ≤9 mm increased after the interventions in both experimental groups (p < .001), indicating induction of FWE. OI outcomes were similar among the groups.

Conclusions

The pharmacological and mechanical interventions are efficient in inducing FWE; outcomes of OI synchronized with FWE should be further investigated.

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Acknowledgments

The authors would like to thank the staff of Centro de Reprodução Humana do Hospital das Clínicas da Faculdade de Medicina da USP for their assistance during this study. The authors would like also to thank Merck Serono for donating all recombinant FSH, hCG and cetrorelix acetate used in this study, and acknowledge the valuable contribution made by Tatiana Bonetti (PhD) in the revision of the manuscript. The first author received a grant from CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior)

This study has been registered at ClinicalTrials.gov as NCT 01668056.

Conflict of interest

The first author received a grant from CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior).

Merck Serono (São Paulo, Brazil) donated the medication used in the study.

Compliance with ethical standards

Our hospital’s Ethics Committee approved this study, and women were only enrolled after signing a written informed consent form.

Author information

Authors and Affiliations

  1. Division of Gynecology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil

    Paulo H. M. Bianchi, Edmund C. Baracat & Paulo C. Serafini

  2. Centro de Reprodução Humana do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil

    Paulo H. M. Bianchi, Gabriela R. F. C. A. Gouveia & Paulo C. Serafini

  3. Department of Animal Reproduction, Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo, São Paulo, SP, Brazil

    Lais M. Viera & Pietro S. Baruselli

  4. Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Harbor, MI, USA

    André M. Rocha

Authors
  1. Paulo H. M. Bianchi
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  2. Lais M. Viera
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  3. Gabriela R. F. C. A. Gouveia
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  4. André M. Rocha
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  5. Pietro S. Baruselli
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  6. Edmund C. Baracat
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  7. Paulo C. Serafini
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Corresponding author

Correspondence to Paulo H. M. Bianchi.

Additional information

Capsule A follicular wave emergence can be elicited through pharmacological and mechanical interventions, but the outcomes of OI synchronized with FWE should be further evaluated

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Bianchi, P.H.M., Viera, L.M., Gouveia, G.R.F.C.A. et al. Study of two strategies to induce follicular wave emergence for assisted reproductive treatments (ART)—a preliminary trial. J Assist Reprod Genet 32, 543–549 (2015). https://doi.org/10.1007/s10815-015-0432-3

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  • DOI: https://doi.org/10.1007/s10815-015-0432-3

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