Experience with a new fixed-stimulation protocol without hormone determinations for programmed oocyte retrieval for...

Area of Science:

• Reproductive endocrinology and infertility treatments.

Background:

• Optimizing ovarian stimulation protocols is crucial for improving in-vitro fertilization (IVF) success rates.
• Current protocols can be complex for patients and may not always yield optimal outcomes.

Purpose of the Study:

• To introduce and evaluate a new fixed schedule for ovarian stimulation in IVF.
• To assess the efficacy and safety of this simplified protocol compared to existing methods.

Main Methods:

• A fixed stimulation schedule initiated with a contraceptive pill to synchronize cycle start, typically on a Sunday.
• Patients received clomiphene (100 mg/day for 5 days) and prednisolone (7.5 mg/day for 30 days).
• Human menopausal gonadotrophin (HMG) (150 IU i.m. every other day) was administered, with follicular growth monitored by daily ultrasound from day 8.
• Human chorionic gonadotrophin (HCG) was administered when the dominant follicle exceeded 18 mm, with minimal blood sampling required.

Main Results:

• The new protocol demonstrated significantly higher fertilization and pregnancy rates per follicular puncture compared to clomiphene-only, clomiphene-HMG/FSH, and HMG/FSH-only protocols.
• Rates of abortion and extrauterine pregnancy were decreased with the new protocol.
• While the number of oocytes retrieved decreased in repeat IVF cycles, the number of fertilized eggs remained consistent, and pregnancy rates increased.

Conclusions:

• The developed fixed schedule for ovarian stimulation offers a simpler and more manageable approach for IVF patients.
• This protocol leads to improved fertilization and pregnancy rates while reducing adverse pregnancy outcomes.
• Repeat IVF cycles using this protocol show enhanced pregnancy success despite a potential reduction in oocyte yield.