Optimizing FSH Concentration Modulation in the Short-Acting GnRH-a Long Protocol for IVF/ICSI: A Retrospective Study

Area of Science:

• Reproductive Endocrinology
• In Vitro Fertilization (IVF)
• Ovarian Stimulation Protocols

Background:

• Exogenous gonadotropins (Gn) are crucial for regulating follicle-stimulating hormone (FSH) levels in IVF/ICSI.
• Optimizing FSH levels is key to achieving a successful ovarian response.

Purpose of the Study:

• To analyze the optimal degree of change in FSH blood concentration in relation to ovarian responsiveness.
• To evaluate ovarian response using a short-acting gonadotropin-releasing hormone agonist (GnRH-a) long protocol for IVF/ICSI.

Main Methods:

• Retrospective study of 794 IVF/ICSI cycles using a short-acting GnRH-a long protocol.
• Ovarian responsiveness assessed by follicle count (>14 mm on HCG trigger day), Refine-FORT, and good quality embryos.
• FSH level changes (Delta 1 and Delta 2) analyzed using linear regression.

Main Results:

• Follicle count >14 mm on HCG trigger day is a suitable indicator of ovarian responsiveness.
• Optimal ovarian response observed when Delta 1 (FSH change from baseline to days 6-8) ranged from 1.94 to 3.37.
• Optimal ovarian response also observed when Delta 2 (FSH change from days 6-8 to HCG trigger) was ≤ -1.58.

Conclusions:

• Identified optimal Delta 1 and Delta 2 ranges for effective ovarian responsiveness in IVF/ICSI.
• The number of follicles >14 mm on HCG trigger day is a novel and effective measure for assessing ovarian response.
• Achieving specific FSH level changes can lead to a higher number and quality of oocytes.