ADJUSTMENT OF GONADOTROPIN DOSAGE BASED ON ESTRADIOL LEVELS DOES NOT WORSEN IVF OUTCOMES

Abstract

Increasing use of GnRH agonist triggers and freeze-all IVF protocols allow physicians greater flexibility with gonadotropin dosing. Historically, human chorionic gonadotropin (HCG) was the only option for trigger in IVF cycles, leading physicians to decrease gonadotropin dosage in response to robust increases in estradiol levels to avoid OHSS. Now physicians often maintain a high gonadotropin dose throughout the cycle in attempt to obtain higher oocyte and embryo yields. However, this must be balanced by the risk of high gonadotropin doses potentially affecting embryo quality and live birth rates as well as patient safety and discomfort.