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Controlled ovarian hyperstimulation for the new reproductive technologies.

D Navot1, B Sandler

  • 1Mount Sinai Medical Center, Department of Obstetrics, Gynecology and Reproductive Science, New York, NY 10029.

Acta Europaea Fertilitatis
|July 1, 1989
PubMed
Summary

This study compared controlled ovarian hyperstimulation (COH) protocols, finding similar pregnancy outcomes across different follicle-stimulating hormone (FSH) and human menopausal gonadotropin (hMG) regimens. The low-dose Lupron (LDL) protocol showed promise for patients with prior COH failure.

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Area of Science:

  • Reproductive endocrinology and infertility
  • Assisted reproductive technologies (ART)

Background:

  • Controlled ovarian hyperstimulation (COH) aims to retrieve multiple oocytes for fertilization.
  • Optimizing COH protocols involves balancing follicle development and oocyte maturity.
  • Previous COH failures necessitate exploring alternative stimulation strategies.

Purpose of the Study:

  • To compare the efficacy of various gonadotropin regimens (hMG and FSH) in COH.
  • To evaluate the success of a low-dose Lupron (LDL) stimulation protocol in patients with prior COH failure.

Main Methods:

  • Four COH protocols were compared: 2hMG, 2hMG + p-FSH, 2 p-FSH, and 4 p-FSH followed by 2 p-FSH.
  • An experimental low-dose Lupron (LDL) protocol using leuprolide acetate was applied to women with previous COH failure (premature luteinization or low response).

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Main Results:

  • Oocyte maturity was higher in protocols not using 2hMG or 2 p-FSH.
  • Preovulatory oocytes, fertilization rates, and pregnancy outcomes were similar across all compared gonadotropin regimens.
  • The LDL protocol demonstrated a favorable estradiol pattern and resulted in fertilizable oocytes in previously unsuccessful patients.

Conclusions:

  • Standard gonadotropin regimens for COH yield comparable pregnancy outcomes.
  • The low-dose Lupron (LDL) protocol shows potential for improving COH success in challenging patient populations.