Stimulation regimens in Assisted Reproductive Technology (ART) programme: experience in the University Hospital,...

Area of Science:

• Reproductive Medicine
• Assisted Reproductive Technology (ART)

Background:

• Ovarian stimulation is crucial for successful Assisted Reproductive Technology (ART) outcomes.
• Two stimulation protocols, 2:1 and Gonadotropin-releasing hormone agonist with Follicle-Stimulating Hormone/Human Menopausal Gonadotropin (GnRHa-FSH/hMG), were compared retrospectively.
• The GnRHa-FSH/hMG protocol was reserved for specific cases including prior LH surge, poor response, or elevated LH levels.

Purpose of the Study:

• To compare the efficacy and outcomes of two ovarian stimulation protocols in an ART program.
• To evaluate cancellation rates, fertilization rates, and pregnancy rates between the 2:1 and GnRHa-FSH/hMG regimens.

Main Methods:

• Retrospective analysis of 241 ART cycles conducted in 1991 at NUH.
• Exclusion of cycles for special research procedures like micro-insemination sperm transfer (MIST).
• Comparison of cancellation reasons, fertilization rates (for IVF-ER and IVF-TET), and pregnancy rates between the two stimulation groups.

Main Results:

• The 2:1 regime had significantly lower cancellation rates (14.4%) compared to the GnRHa-FSH/hMG regime (37.3%).
• Cancellations for the 2:1 regime were mainly due to premature ovulation, while GnRHa-FSH/hMG cancellations were primarily due to poor response.
• The 2:1 regime showed higher pregnancy rates (16.4%–23.3%) than the GnRHa-FSH/hMG regime (9.8%–18.8%), despite lower fertilization rates.

Conclusions:

• The 2:1 ovarian stimulation protocol appears more effective in achieving higher pregnancy rates in ART compared to the GnRHa-FSH/hMG protocol.
• The choice of stimulation protocol significantly impacts cancellation rates and reasons for cancellation in ART.
• Further investigation may be warranted to optimize stimulation protocols for individual patient profiles in ART programs.