Clinical outcomes using a flexible regimen of GnRH-antagonists and a ‘step-up’ of additional gonadotropins in donor oocyte cycles

ABSTRACT Objective: To assess the impact of serum estradiol upon oocyte donor cycle stimulation characteristics and clinical outcomes using flexible GnRH-antagonist (GnRH‑ant) with additional FSH supplementation. Research design and methods: A retrospective chart review of 99 oocyte donor cycles usi...

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Bibliographic Details
Published in:Current medical research and opinion 2007-09, Vol.23 (9), p.2297-2302
Main Authors: Barker, M. A., Christianson, M. S., Schouweiler, C. M., Lindheim, S. R.
Format: Article
Language:English
Subjects:
Adult
Clinical outcomes
Female
GnRH-antagonists
Gonadotropin-Releasing Hormone - antagonists & inhibitors
Gonadotropins - administration & dosage
Humans
IVF-ET
Middle Aged
Oocyte donation
Oocytes - transplantation
Ovulation induction
Pregnancy
Pregnancy Rate
Tissue Donors
Treatment Outcome
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Summary:ABSTRACT Objective: To assess the impact of serum estradiol upon oocyte donor cycle stimulation characteristics and clinical outcomes using flexible GnRH-antagonist (GnRH‑ant) with additional FSH supplementation. Research design and methods: A retrospective chart review of 99 oocyte donor cycles using ovarian hyperstimulation with recombinant FSH (rFSH) and GnRH‑ant was analyzed. Following discontinuation of oral contraceptives, controlled ovarian hyperstimulation was begun using rFSH (150–300 IU daily). GnRH‑ant (ganirelix, Organon) and an additional 75 IU of FSH/day were begun when lead follicles were 13–14 mm in greatest diameter. Cycles were analyzed based on serum estradiol response following administration of GnRH‑ant (Group 1: progressive rise and Group 2: no rise or a decline). Primary endpoints were cycle stimulation characteristics based on serum estradiol following GnRH‑ant, clinical pregnancy and implantation rates. Results: A decline in serum estradiol was seen after GnRH‑ant administration in 45% of cycles. Clinical pregnancy rates per transfer (70 vs. 72%) and implantation rates (43 vs. 56%) were similar for each group. Conclusion: Flexible regimens of GnRH‑ant even with additional rFSH in a ‘step-up’ fashion frequently result in a decline in serum estradiol during ovulation induction. While our study is non-randomized, it does not appear to result in any adverse affect in clinical outcomes in donor oocyte cycles.
ISSN:0300-7995
1473-4877
DOI:10.1185/030079907X219689