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document
What is the optimum maximal gonadotropin dosage used in microdose flare-up cycles in poor responders ? OBJECTIVE To find out the optimum maximal dosage of recombinant follicle stimulating hormone ( rFSH ) in microdose gonadotropin-releasing hormone analog ( GnRH-a ) flare cycles in poor responders . DESIGN Prospective randomized study . SETTING Private infertility clinic . PATIENT ( S ) A total of 119 women were taken into the study . INTERVENTION ( S ) The study group underwent a microdose protocol with a GnRH-agonist followed by rFSH administration . On the third day of GnRH-a administration , 119 patients were randomized in three groups to receive daily fixed doses of 300 IU of rFSH ( group A , n = 38 ) , or 450 IU of rFSH ( group B , n = 39 ) , or 600 IU of rFSH ( group C , n = 42 ) . MAIN OUTCOME MEASURE ( S ) Peak E ( 2 ) levels , days of stimulation with rFSH , total rFSH dosage , total number of oocytes retrieved , M2 oocytes retrieved , total number of embryos , number of embryos transferred , number of Grade-1 embryos transferred , clinical pregnancy rate ( positive fetal cardiac activity ) , and cancellation rates of stimulation and embryo transfer . RESULT ( S ) Clinical pregnancy rates were 13.1 % , 15.3 % , and 16.1 % for group A , group B , and group C , respectively . There were no significant differences in the age , peak serum E ( 2 ) concentration , days of stimulation with rFSH , total number of M2 oocytes retrieved , number of embryos transferred , clinical pregnancy rates , and cancellation rates of stimulation and embryo transfer between the three groups except for total rFSH dosage . CONCLUSION ( S ) There is no need to use doses above 300 IU of rFSH to increase the pregnancy rate in microdose cycles . In addition , because the duration of stimulation does not differ between the groups , the usage of 300 IU rFSH in microdose cycles results in less total amount of rFSH consumed in a cycle compared with higher dosages , and this would obviously cost less money to the patients .
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Intervention_Pharmacological
gonadotropin
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Intervention_Physical
recombinant follicle stimulating hormone ( rFSH )
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Intervention_Pharmacological
gonadotropin-releasing hormone analog ( GnRH-a )
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Intervention_Physical
GnRH-agonist
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Intervention_Physical
rFSH administration
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Intervention_Pharmacological
GnRH-a
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Intervention_Physical
rFSH
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Intervention_Pharmacological
rFSH
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Intervention_Pharmacological
rFSH
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Intervention_Physical
rFSH
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Intervention_Physical
rFSH
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Intervention_Physical
rFSH
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Intervention_Physical
rFSH
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Intervention_Physical
rFSH
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Intervention_Physical
rFSH
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Intervention_Physical
rFSH
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Outcome_Adverse-effects
Peak E ( 2 ) levels , days of stimulation with rFSH , total rFSH dosage , total number of oocytes retrieved , M2 oocytes retrieved , total number of embryos , number of embryos transferred , number of Grade-1 embryos transferred , clinical pregnancy rate ( positive fetal cardiac activity ) , and cancellation rates of stimulation and embryo transfer .
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Outcome_Physical
Clinical pregnancy rates
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Outcome_Physical
peak serum E ( 2 ) concentration , days of stimulation with rFSH , total number of M2 oocytes retrieved , number of embryos transferred , clinical pregnancy rates , and cancellation rates
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Participant_Condition
microdose flare-up cycles in poor responders