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MILD ovarian stimulation with GnRH-antagonist vs. long protocol with low dose FSH for non-PCO high responders undergoing IVF: a prospective, randomized study including thawing cycles

Journal of Assisted Reproduction and Genetics volume 29, pages 1343–1351 (2012)Cite this article

Abstract

Objective

To compare the effectiveness of two stimulation protocols in non-polycystic ovary (PCO) high responders undergoing in vitro fertilization (IVF).

Design

Prospective randomized trial.

Setting

A Reproductive Medicine and IVF Unit of a University Hospital and a private IVF Clinic.

Methods

Four hundred-and-twelve normoovulatory women with good ovarian responsiveness were randomized to receive either the “mild” (FSH 150 IU/day from day 4 of a spontaneous cycle followed by GnRH-antagonist from day 8; n = 205) or the “long” (FSH 150 IU/day; n = 207) stimulation protocol. The outcome of these two regimens was compared including “fresh” and thawing cycles.

Results

The total FSH dose and the peak estradiol level were significantly lower in the “mild” protocol, whereas the retrieved oocytes, fertilization rate, number and quality of embryos, pregnancy and implantation rates, cumulative “fresh plus thaw” success rate, and incidence of severe ovarian hyperstimulation syndrome were comparable with the two regimens.

Conclusions

In young, normoovulatory patients with good ovarian responsiveness undergoing IVF the “mild” stimulation protocol has effectiveness and risks comparable to the “long” protocol with low FSH starting dose, even when thawing cycles are included in the comparison.

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Competing interests

The authors declare that they have no competing interests.

Authors’ contribution

SC, GP and AP collected the data. SC provided the first draft of the manuscript. GG and DG participated in the design of the study and performed the statistical analysis. AR conceived the study, participated in its design and coordination, and helped to draft the manuscript. All authors read and approved the final manuscript.

Author information

Affiliations

  1. Physiopathology of Reproduction and IVF Unit, Department of Obstetrical and Gynecological Sciences, University of Torino, via Ventimiglia 3, 10126, Torino, Italy

    Simona Casano, Ambra Patriarca, Giulia Pittatore, Gianluca Gennarelli & Alberto Revelli

  2. LIVET infertility and IVF Clinic, via Tiziano 3, 10126, Torino, Italy

    Daniela Guidetti, Gianluca Gennarelli & Alberto Revelli

Authors
  1. Simona Casano
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  2. Daniela Guidetti
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  3. Ambra Patriarca
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  4. Giulia Pittatore
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  5. Gianluca Gennarelli
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  6. Alberto Revelli
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Corresponding author

Correspondence to Alberto Revelli.

Additional information

Capsule

Mild stimulation vs. long protocol in non-PCO high responders.

Appendix

Appendix

Table 4 CONSORT 2010 checklist of information to include when reporting a randomised trial*
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Casano, S., Guidetti, D., Patriarca, A. et al. MILD ovarian stimulation with GnRH-antagonist vs. long protocol with low dose FSH for non-PCO high responders undergoing IVF: a prospective, randomized study including thawing cycles. J Assist Reprod Genet 29, 1343–1351 (2012). https://doi.org/10.1007/s10815-012-9863-2

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  • DOI: https://doi.org/10.1007/s10815-012-9863-2

Keywords

  • Mild ovarian stimulation
  • IVF
  • GnRH antagonist
  • FSH