Clomiphene based ovarian stimulation in a commercial donor program.

Area of Science:

• Reproductive Endocrinology
• Assisted Reproductive Technologies

Background:

• Ovarian stimulation protocols are crucial in assisted reproduction.
• The conventional antagonist protocol is widely used but can be costly and impact endometrial quality.

Purpose of the Study:

• To compare an extended clomiphene-based ovarian stimulation regimen with the conventional antagonist protocol in donor-recipient cycles.
• To evaluate the efficacy and cost-effectiveness of clomiphene in ovarian stimulation.

Main Methods:

• Retrospective analysis of 170 donor cycles.
• Group I: Conventional antagonist protocol (n=31).
• Group II: Extended clomiphene regimen (50 mg daily with gonadotropins) (n=139).

Main Results:

• The clomiphene group showed significantly higher pregnancy rates (OR: 2.453, P=0.02) and fertilization rates (P=0.04).
• No unsuccessful egg retrievals occurred in the clomiphene group.
• Lower gonadotropin dosage (P<0.001) and terminal estradiol levels were observed in the clomiphene group.

Conclusions:

• Clomiphene effectively prevents luteinizing hormone surge during ovarian stimulation.
• The clomiphene regimen reduces gonadotropin dosage, leading to lower costs.
• This protocol positively impacts endometrial and oocyte quality.