Changing stimulation protocol on repeat conventional ovarian stimulation cycles does not lead to improved laboratory outcomes

نویسندگان

چکیده

ObjectiveTo evaluate whether physicians’ choice of ovarian stimulation protocol is associated with laboratory outcomes.DesignRetrospective cohort study.SettingSingle academic center.Patient(s)The subjects were 4,458 patients who completed more than one in vitro fertilization cycle within 1 year. On second stimulation, 49% repeated the same and 51% underwent a different one.Intervention(s)Estradiol priming antagonist, antagonist +/– oral contraceptive pill priming, long luteal protocol, Lupron (Lupron [AbbVie Inc, North Chicago, IL]) stop flare compared. Logistic or linear regression cluster robust standard errors to account for covariates paired data was used.Main Outcome Measure(s)Oocytes collected (OC), rate, blastocyst progression (BP), usable embryos (UE), euploid rate (ER).Result(s)First outcomes comparable across all protocols FR, BP, UE, ER but OC, after adjustment covariates. For effect switching differed according type stimulation. There improvement OC if repeated, except flare. In addition, there slight, significant improvements (difference values coefficient 0.02; 95% confidence interval [CI], 0.004, 0.4) UE (coefficient 1.25; CI, 0.79, 1.72) when repeated. no changes BP 0.03; –0.01, 0.08) 0.01; –0.04, 0.06) changed. low-BP subgroup, greater seen CI 0.01, 0.04).Conclusion(s)There slight so careful consideration should be made before purpose improving outcomes. To Retrospective study. Single center. The one. Estradiol used. Oocytes (ER). First 0.04).

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ژورنال

عنوان ژورنال: Fertility and Sterility

سال: 2021

ISSN: ['0015-0282', '1556-5653']

DOI: https://doi.org/10.1016/j.fertnstert.2021.04.030