Unlocking Success: The Optimal Gonadotrophin Starting Point for Luteal-Phase Stimulation in IVF Patients with Normal...

Area of Science:

• Reproductive Endocrinology
• In Vitro Fertilization

Background:

• Luteal-phase stimulation (LPS) is an alternative to follicular-phase stimulation (FPS) in in vitro fertilization (IVF).
• Determining the optimal timing for initiating gonadotrophin (Gn) in LPS for normal ovarian response (NOR) patients is crucial for maximizing treatment efficacy.

Purpose of the Study:

• To identify the optimal starting point for gonadotrophin (Gn) administration in luteal-phase stimulation (LPS) protocols.
• To compare the efficacy of different Gn initiation timings within LPS and against traditional follicular-phase stimulation (FPS) in NOR patients undergoing IVF/intracytoplasmic sperm injection (ICSI).

Main Methods:

• Retrospective analysis of 199 IVF/ICSI cycles from 2021-2023.
• Patients were categorized into FPS (n=121) and LPS (n=78) groups.
• The LPS group was further divided into early, mid-, and late Gn initiation subgroups for comparative analysis of outcomes.

Main Results:

• The late LPS subgroup demonstrated a significantly higher rate of high-quality embryos compared to the early LPS subgroup.
• Clinical pregnancy and live birth rates were slightly higher in the late LPS group versus early and mid-LPS subgroups.
• Outcomes in the late LPS group were comparable to those achieved with traditional FPS protocols.

Conclusions:

• Initiating Gn stimulation during the late luteal phase is the optimal strategy for NOR patients undergoing IVF.
• This timing appears to enhance embryo quality and clinical outcomes in LPS protocols.