Introduce an optimal method of ovarian stimulation in the polycystic ovarian syndrome affected: a randomized controlled trial.

Pregnancy Female Humans Ovarian Hyperstimulation Syndrome / prevention & control Polycystic Ovary Syndrome / therapy Gonadotropin-Releasing Hormone Ovulation Induction / methods Gonadotropins / therapeutic use Fertilization in Vitro / methods Pregnancy Rate Follicle Stimulating Hormone / therapeutic use
GnRH-antagonist Human menopausal gonadotropin Mild ovarian stimulation Minimal ovarian stimulation Polycystic ovarian syndrome Recombinant FSH

Journal

BMC women's health
ISSN: 1472-6874
Titre abrégé: BMC Womens Health
Pays: England
ID NLM: 101088690

Informations de publication

Date de publication:
20 06 2023
Historique:
received: 14 09 2022
accepted: 10 06 2023
medline: 22 6 2023
pubmed: 21 6 2023
entrez: 20 6 2023
Statut: epublish

Résumé

Currently, optimal method of ovarian stimulation (OS) to in-vitro fertilization (IVF) in the patients with polycystic ovarian syndrome (PCOS) is unknown. The present research aims to study the efficiency of minimal-OS method in treatment of infertile patients with PCOS and also the effect of gonadotropin type (recombinant FSH (r-FSH) vs. urinary Human menopausal gonadotropin (u-HMG)) on treatment cycles with GnRH-antagonist. In this randomized controlled trial, a total of 120 eligible patients were randomly allocated into four groups of OS to IVF: minimal-OS with r-FSH, minimal-OS with u-HMG, mild-OS with r-FSH and mild-OS with u-HMG. IVF outcomes of groups were analyzed statically. The statistical analysis showed that there were significant differences among groups regarding stimulation duration (p < 0.0001), number of retrieved oocytes (p < 0.0001), number of obtained embryos (p < 0.0001). There were no statistically significant differences in fertilization rate (p = 0.289) and implantation rate (p = 0.757) among our participants. There were also significant differences among these four groups in terms of clinical pregnancy rate (/ET and /cycles) (p < 0.0001, p = 0.021, respectively) and live birth rate/cycles (p < 0.0001). Also cases of freeze all embryos due to prevention of ovarian hyper stimulation syndrome (OHSS) (p = 0.004). On the basis of present results the minimal-OS with u-HMG may be one of optimal methods of control OS in the patients with PCOS in respect to serum levels of estradiol on the day of triggering final oocyte maturation, total dose of prescribed gonadotropin, the optimal number of oocytes and embryos obtained, rate of clinical pregnancy and the incidence of OHSS risk. NCT, NCT03876145. Registered 15/03/2019. Retrospectively registered, http://www. gov/ NCT03876145.

Sections du résumé

BACKGROUND
Currently, optimal method of ovarian stimulation (OS) to in-vitro fertilization (IVF) in the patients with polycystic ovarian syndrome (PCOS) is unknown. The present research aims to study the efficiency of minimal-OS method in treatment of infertile patients with PCOS and also the effect of gonadotropin type (recombinant FSH (r-FSH) vs. urinary Human menopausal gonadotropin (u-HMG)) on treatment cycles with GnRH-antagonist.
METHODS
In this randomized controlled trial, a total of 120 eligible patients were randomly allocated into four groups of OS to IVF: minimal-OS with r-FSH, minimal-OS with u-HMG, mild-OS with r-FSH and mild-OS with u-HMG. IVF outcomes of groups were analyzed statically.
RESULTS
The statistical analysis showed that there were significant differences among groups regarding stimulation duration (p < 0.0001), number of retrieved oocytes (p < 0.0001), number of obtained embryos (p < 0.0001). There were no statistically significant differences in fertilization rate (p = 0.289) and implantation rate (p = 0.757) among our participants. There were also significant differences among these four groups in terms of clinical pregnancy rate (/ET and /cycles) (p < 0.0001, p = 0.021, respectively) and live birth rate/cycles (p < 0.0001). Also cases of freeze all embryos due to prevention of ovarian hyper stimulation syndrome (OHSS) (p = 0.004).
CONCLUSIONS
On the basis of present results the minimal-OS with u-HMG may be one of optimal methods of control OS in the patients with PCOS in respect to serum levels of estradiol on the day of triggering final oocyte maturation, total dose of prescribed gonadotropin, the optimal number of oocytes and embryos obtained, rate of clinical pregnancy and the incidence of OHSS risk.
TRIAL REGISTRATION
NCT, NCT03876145. Registered 15/03/2019. Retrospectively registered, http://www.
CLINICALTRIAL
gov/ NCT03876145.

Identifiants

DOI: 10.1186/s12905-023-02473-2 PMID: 37340371 PMC: PMC10283261
pubmed: 37340371
doi: 10.1186/s12905-023-02473-2
pii: 10.1186/s12905-023-02473-2
pmc: PMC10283261
doi:

Substances chimiques

Gonadotropin-Releasing Hormone 33515-09-2
Gonadotropins 0
Follicle Stimulating Hormone 9002-68-0

Banques de données

ClinicalTrials.gov
['NCT03876145']

Types de publication

Randomized Controlled Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

323

Informations de copyright

© 2023. The Author(s).

Références

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Auteurs

Azar Yahyaei (A)

Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

Samira Vesali (S)

Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

Firouzeh Ghaffari (F)

Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran. ghafaryf@yahoo.com.

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Classifications MeSH

questionsmedicales.fr › Phénomènes physiologiques des appareils urinaire et reproducteur › Phénomènes physiologiques de la reproduction › Reproduction › Grossesse › Introduce an optimal method of ovarian...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Introduce an optimal method of ovarian...
questionsmedicales.fr › Maladies endocriniennes › Troubles gonadiques › Maladies ovariennes › Syndrome d'hyperstimulation ovarienne › Introduce an optimal method of ovarian...
questionsmedicales.fr › Maladies endocriniennes › Troubles gonadiques › Maladies ovariennes › Kystes de l'ovaire › Syndrome des ovaires polykystiques › Introduce an optimal method of ovarian...
questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Protéines de tissu nerveux › Neuropeptides › Hormones hypothalamiques › Hormones hypophysiotropes libératrices › Hormone de libération des gonadotrophines › Introduce an optimal method of ovarian...
questionsmedicales.fr › Techniques d'investigation › Techniques de reproduction › Techniques de reproduction assistée › Induction d'ovulation › Introduce an optimal method of ovarian...
questionsmedicales.fr › Gonadotrophines › Introduce an optimal method of ovarian...
questionsmedicales.fr › Techniques d'investigation › Techniques de reproduction › Techniques de reproduction assistée › Fécondation in vitro › Introduce an optimal method of ovarian...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Registre civil › Taux de grossesse › Introduce an optimal method of ovarian...
questionsmedicales.fr › Acides aminés, peptides et protéines › Peptides › Hormones peptidiques › Hormones hypophysaires › Hormones antéhypophysaires › Gonadotrophines hypophysaires › Hormone folliculostimulante › Introduce an optimal method of ovarian...