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A novel protocol of ovulation induction with delayed gonadotropin-releasing hormone antagonist administration combined with high-dose recombinant follicle-stimulating hormone and clomiphene citrate for poor responders and women over 35 years.
Fertil Steril. 2004 Jun; 81(6):1572-7.FS

Abstract

OBJECTIVE

To evaluate the efficacy of a novel protocol of ovulation induction for poor responders.

DESIGN

Prospective, controlled, clinical study.

SETTING

Research institute's reproductive unit.

PATIENT(S)

One hundred forty-five infertile women, aged 27-39 years, candidates for assisted reproductive techniques (ART).

INTERVENTION(S)

Before undergoing ART, 85 patients received clomiphene citrate, high-dose recombinant human FSH, and a delayed, multidose GnRH antagonist, whereas 60 patients underwent a standard long protocol.

MAIN OUTCOME MEASURE(S)

Estradiol levels (pg/mL), cancellation rate, oocyte retrieval, embryo score, and fertilization and pregnancy rates.

RESULT(S)

Patients undergoing the study protocol obtained lower cancellation rates (4.7% vs. 34%) and higher E(2) levels (945.88 +/- 173.2 pg/mL vs. 169.55 +/- 45.07 pg/mL), oocyte retrieval (5.56 +/- 1.13 vs. 3.36 +/- 1.3), and pregnancy (22.2% vs. 15.3%) and implantation rates (13.5% vs. 7.6%) compared with those receiving the long protocol. Age negatively correlated with ovarian response in the latter, whereas the ovarian outcome results were comparable in younger (<35 yrs) and older (>35 yrs) women treated with the study protocol.

CONCLUSION(S)

The proposed protocol of ovulation induction can be usefully administered in poor responders as well as in aged woman, probably because the delayed administration of GnRH antagonist prevents its adverse effects on ovarian paracrine activity and on oocyte maturation.

Authors+Show Affiliations

Unità Operativa di Fisiopatologia della Riproduzione Umana, IRCCS "S. De Bellis," Castellana Grotte (Ba), Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

15193479

Citation

D'Amato, Giuseppe, et al. "A Novel Protocol of Ovulation Induction With Delayed Gonadotropin-releasing Hormone Antagonist Administration Combined With High-dose Recombinant Follicle-stimulating Hormone and Clomiphene Citrate for Poor Responders and Women Over 35 Years." Fertility and Sterility, vol. 81, no. 6, 2004, pp. 1572-7.
D'Amato G, Caroppo E, Pasquadibisceglie A, et al. A novel protocol of ovulation induction with delayed gonadotropin-releasing hormone antagonist administration combined with high-dose recombinant follicle-stimulating hormone and clomiphene citrate for poor responders and women over 35 years. Fertil Steril. 2004;81(6):1572-7.
D'Amato, G., Caroppo, E., Pasquadibisceglie, A., Carone, D., Vitti, A., & Vizziello, G. M. (2004). A novel protocol of ovulation induction with delayed gonadotropin-releasing hormone antagonist administration combined with high-dose recombinant follicle-stimulating hormone and clomiphene citrate for poor responders and women over 35 years. Fertility and Sterility, 81(6), 1572-7.
D'Amato G, et al. A Novel Protocol of Ovulation Induction With Delayed Gonadotropin-releasing Hormone Antagonist Administration Combined With High-dose Recombinant Follicle-stimulating Hormone and Clomiphene Citrate for Poor Responders and Women Over 35 Years. Fertil Steril. 2004;81(6):1572-7. PubMed PMID: 15193479.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A novel protocol of ovulation induction with delayed gonadotropin-releasing hormone antagonist administration combined with high-dose recombinant follicle-stimulating hormone and clomiphene citrate for poor responders and women over 35 years. AU - D'Amato,Giuseppe, AU - Caroppo,Ettore, AU - Pasquadibisceglie,Annamaria, AU - Carone,Domenico, AU - Vitti,Angela, AU - Vizziello,Giovanni Michele, PY - 2003/05/05/received PY - 2004/01/12/revised PY - 2004/01/12/accepted PY - 2004/6/15/pubmed PY - 2004/7/15/medline PY - 2004/6/15/entrez SP - 1572 EP - 7 JF - Fertility and sterility JO - Fertil Steril VL - 81 IS - 6 N2 - OBJECTIVE: To evaluate the efficacy of a novel protocol of ovulation induction for poor responders. DESIGN: Prospective, controlled, clinical study. SETTING: Research institute's reproductive unit. PATIENT(S): One hundred forty-five infertile women, aged 27-39 years, candidates for assisted reproductive techniques (ART). INTERVENTION(S): Before undergoing ART, 85 patients received clomiphene citrate, high-dose recombinant human FSH, and a delayed, multidose GnRH antagonist, whereas 60 patients underwent a standard long protocol. MAIN OUTCOME MEASURE(S): Estradiol levels (pg/mL), cancellation rate, oocyte retrieval, embryo score, and fertilization and pregnancy rates. RESULT(S): Patients undergoing the study protocol obtained lower cancellation rates (4.7% vs. 34%) and higher E(2) levels (945.88 +/- 173.2 pg/mL vs. 169.55 +/- 45.07 pg/mL), oocyte retrieval (5.56 +/- 1.13 vs. 3.36 +/- 1.3), and pregnancy (22.2% vs. 15.3%) and implantation rates (13.5% vs. 7.6%) compared with those receiving the long protocol. Age negatively correlated with ovarian response in the latter, whereas the ovarian outcome results were comparable in younger (<35 yrs) and older (>35 yrs) women treated with the study protocol. CONCLUSION(S): The proposed protocol of ovulation induction can be usefully administered in poor responders as well as in aged woman, probably because the delayed administration of GnRH antagonist prevents its adverse effects on ovarian paracrine activity and on oocyte maturation. SN - 0015-0282 UR - https://www.unboundmedicine.com/medline/citation/15193479/A_novel_protocol_of_ovulation_induction_with_delayed_gonadotropin_releasing_hormone_antagonist_administration_combined_with_high_dose_recombinant_follicle_stimulating_hormone_and_clomiphene_citrate_for_poor_responders_and_women_over_35_years_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015028204002158 DB - PRIME DP - Unbound Medicine ER -