[Comparison of ovulation induction protocols for in vitro fertilization]

Area of Science:

• Reproductive Endocrinology
• In Vitro Fertilization (IVF)
• Assisted Reproductive Technology (ART)

Background:

• Controlled ovarian hyperstimulation (COH) protocols are crucial for in vitro fertilization (IVF) success.
• Optimizing COH protocols is essential for improving pregnancy rates in patients undergoing multiple IVF attempts.
• Previous IVF cycles reaching embryo transfer (ET) without conception indicate a need to evaluate alternative COH strategies.

Purpose of the Study:

• To retrospectively evaluate and compare the efficacy of four distinct COH protocols in patients with a history of failed IVF cycles.
• To determine if any specific COH protocol demonstrates superior pregnancy rates in patients who have previously achieved embryo transfer but not conception.
• To provide evidence-based recommendations regarding protocol adjustments in recurrent IVF failure cases.

Main Methods:

• Retrospective analysis of 426 in vitro fertilization (IVF) treatment cycles from cycle 4 through 8.
• Inclusion of patients who reached embryo transfer (ET) in three prior attempts without conception.
• Evaluation of four COH protocols: menotropins, clomiphene citrate/hMG, and GnRH analog short/long protocols with hMG.

Main Results:

• No statistically significant differences were observed in pregnancy rates per cycle across the four evaluated COH protocols.
• Patient demographics, infertility factors, and protocol distribution were comparable among the study groups.
• The study found no evidence to support switching COH protocols in cases of repeated embryo transfer without pregnancy.

Conclusions:

• The choice of controlled ovarian hyperstimulation (COH) protocol does not significantly impact pregnancy outcomes in patients with prior embryo transfer failures.
• Current evidence does not justify altering a COH regimen solely based on previous IVF attempts that reached embryo transfer but not conception.
• Further research may be needed to identify other factors influencing IVF success beyond COH protocol selection in this patient population.