Infertility Research Today is a free monthly online journal that collates and summarizes the latest research about Infertility, including details on male and female infertility, treatment, causes, pregnancy. | ||||||||
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"Ovarian age-based" stimulation of young women with diminished ovarian reserve results in excellent pregnancy rates with in vitro fertilization.Gleicher N, Barad D Center for Human Reproduction, New York, New York 10021, USA. ngleicher@thechr.com <ngleicher@thechr.com> OBJECTIVE: To determine whether pregnancy outcome can be positively affected if the ovarian stimulation in women with diminished ovarian reserve (DOR) is changed. DESIGN: Case control study. SETTING: Medical school-affiliated private infertility center. PATIENT(S): Sixty-two women, aged 26-35 years, with the diagnosis of DOR (study group) and 62 age-matched controls with apparently normal ovarian function (control group). INTERVENTION(S): Study group patients received a modified (ovarian age-based) stimulation with microdose GnRH agonist (GnRH-a) and 450-600 IU of gonadotropin daily. Women in the control group received a standard "chronological age-based" stimulation with long luteal phase GnRH-a and up to 300 IU of gonadotropins (two patients in this group received an antagonist in place of an agonist). MAIN OUTCOME MEASURE(S): The IVF cycle outcome parameters, including pregnancy rates (PR). RESULT(S): Women with DOR and controls did not differ significantly in patient profiles or underlying infertility conditions and received identical embryo numbers at transfer. The DOR patients demonstrated a strong trend toward lower gravidity. Peak E(2) levels were similar between groups but controls produced significantly more oocytes, a strong trend toward more embryos and significantly more cycles of cryopreservation. Both groups achieved a 47% rate of first positive pregnancy test (hCG), with controls demonstrating a 39% and DOR patients a 32% ongoing PR. CONCLUSION(S): Women with DOR, if treated with an ovarian age-based rather than chronological age-based ovarian stimulation protocols, will demonstrate surprisingly good PR with IVF in comparison to women with normal ovarian function. Published 27 November 2006 in Fertil Steril, 86(6): 1621-5.
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