[High doses of gonadotropins for controlled ovarian hyperstimulation: A case-control study]

Area of Science:

• Reproductive Endocrinology
• In Vitro Fertilization
• Ovarian Stimulation Protocols

Background:

• Assisted reproductive technology (ART) is globally increasing, yet ovarian stimulation in poor responders remains challenging.
• No consensus exists on optimal protocols, molecules, or dosages for poor responders undergoing ART.
• This study addresses the need for evidence-based ovarian stimulation strategies in patients at risk of poor ovarian response.

Purpose of the Study:

• To compare ovarian stimulation and IVF outcomes in patients at risk of poor ovarian response.
• To evaluate the efficacy of high-dose gonadotropins (≥450IU/day) versus conventional doses (300IU/day) in antagonist protocols.
• To provide data for optimizing ovarian stimulation protocols in challenging patient populations.

Main Methods:

• Retrospective monocentric case-control study conducted in 2013.
• Compared antagonist cycles using ≥450IU/day gonadotropins with matched control cycles using 300IU/day.
• Matching criteria included ART type, age, anti-Müllerian hormone (AMH), and body mass index (BMI).

Main Results:

• 82 high-dose cycles were matched with 82 control cycles.
• Groups were comparable, though high-dose group had higher poor responder prevalence and IVF rank.
• No significant differences observed in oocyte yield, embryo development, fertilization, implantation, or ongoing pregnancy rates.

Conclusions:

• Current ovarian stimulation protocols lack demonstrated superiority for expected poor responders.
• High-dose gonadotropin stimulation (≥450IU/day) showed no significant advantage over conventional doses (300IU/day) in IVF outcomes.
• Further research may be needed to refine ovarian stimulation strategies for poor responders.