Total follicle stimulating hormone dose is negatively correlated with live births in a donor/recipient model with fresh transfer: an analysis of 8,627 cycles from the Society for Assisted Reproductive Technology Registry

Total follicle-stimulating hormone (FSH) dosage was negatively associated with live births in the donor population. Avoiding excessive FSH dosing for donors is imperative for optimal fresh success in the recipient.
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VOLUME 114, ISSUE 3, P545-551

Authors:

Kathryn L. Shaia, M.D., M.H.A., Kelly S. Acharya, M.D., Benjamin S. Harris, M.D., M.P.H., Jeremy M. Weber, M.S., Tracy Truong, M.S., Suheil J. Muasher, M.D.

Abstract:

Objective

Oocyte donation has optimized our understanding of ovarian stimulation. Increasing the follicle-stimulating hormone (FSH) dose has been shown to adversely affect live birth rates in autologous cycles. Our objective is to assess whether this relationship holds true within the donor/recipient population.

Design

Retrospective cohort study.

Setting

Not applicable.

Patients

Data from 2014−2016 included 8,627 fresh donor cycles.

Interventions

None.

Main outcome measures

Live birth, clinical pregnancy, and miscarriage rates.

Results

The mean donor age ± standard deviation (SD) was 25.8 ± 2.8 years. Donors underwent a median of 16 days (interquartile range [IQR] 12, 19) of stimulation with a median (IQR) total FSH dose and daily dose of 2,350.0 (1,800.0, 3,025.0) and 153.8 (113.2, 205.0) IU, respectively. The live birth rate was 56.7% per transfer. For every 500-unit increase in FSH dose, there was a 3% reduction in the odds of a live birth (odds ratio [OR] 0.97; 95% confidence interval 0.95, 0.99), and a 3% reduction in the odds of a clinical pregnancy (OR 0.97; 95% confidence interval 0.95, 0.99). Days of stimulation and average daily dose were not significantly associated with live birth or clinical pregnancy. No significant association was found between miscarriage rates and total FSH dose, days of stimulation, or average daily dose.

Conclusion

This is a novel report of a negative association of total FSH dosage on fresh IVF live births, performed in the donor population to control for oocyte source and endometrial receptivity.

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