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