Gonadotropin dose is negatively correlated with live birth rate Analysis of more than 650000 assisted reproductive technology cycles

Live birth rate decreased with increasing follicle stimulating hormone dose, regardless of number of oocytes retrieved.

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Authors

Valerie L. Baker, M.D., Morton B. Brown, Ph.D., Barbara Luke, Sc.D., M.P.H., George W. Smith, Ph.D., James J. Ireland, Ph.D.

Volume 104, Issue 5, Pages 1145-1152

Abstract

Objective:

To evaluate the correlation between total gonadotropin dose and live birth rate.

Design:

Retrospective analysis.

Setting:

Not applicable.

Patient(s):

A total of 658,519 fresh autologous cycles of in vitro fertilization (IVF) reported to the Society for Assisted Reproductive Technology from 2004 to 2012.

Intervention(s):

None.

Main Outcome Measure(s):

Logistic regression models were fitted to live birth rates with the use of categorized values for total FSH dose and number of oocytes retrieved as the primary predictor variables. To reduce the effect of the most significant confounders that may lead physicians to prescribe higher doses of FSH, additional analyses were performed limited to good-prognosis patients (<35 years of age, body mass index <30 kg/m2, and no diagnosis of diminished ovarian reserve, endometriosis, or ovulatory disorder) and including duration of gonadotropin treatment. Result(s):

Live birth rate significantly decreased with increasing FSH dose, regardless of the number of oocytes retrieved. The statistically significant decrease in live birth rate with increasing FSH dose remained in patients with good prognosis, and regardless of female age, except for women aged ≥35 years with 1–5 oocytes retrieved.

Conclusion(s):

This analysis suggests that physicians may wish to avoid prescribing a high dose of FSH. However, the results of this study do not justify the use of minimal-stimulation or natural-cycle IVF.

Read the full text at: http://www.fertstert.org/article/S0015-0282(15)01663-5/fulltext


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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