Abstract
OBJECTIVE: Most ART programs split the daily gonadotropin dose during ovarian stimulation when the dose exceeds 4 vials daily. There is a lack of studies in the literature addressing whether this practice alters ART outcomes. DESIGN: Prospective, Randomized. MATERIALS AND METHODS: A prospective analysis of 191 IVF/ICSI cycles were randomized to receive either once daily or twice daily injections of FSH and hMG SC. For those patients receiving twice daily injections, both hMG (Menopur®) and FSH (Bravelle®) were given in the am and pm. Patients recieving once daily injections, hMG and FSH were given in the pm. Included in the study were LL (n=152), MD flare (n=8) and antagonist cycles (n=31). P<0.05 was considered significant. RESULTS: Of the 191 total cycles, 155 (81.2%) resulted in pregnancies. A total of 99 cycles had once daily gonadotropin injections with a 69.7% clinical pregnancy rate. This is compared with 92 cycles with twice daily gonadotopin injections with a 72.8 % clinical pregnancy rate. No significant differences were found for demographic data. There was a significant difference with BID requiring more FSH.Table 1Treatment and outcome measures.TreatmentNo.Stimulation length (days)Total FSH (vials)Total hMG (vials)Oocytes retrievedPositive Beta hCG (%)Clinical Pregnancy (%)Once999.98 ± 0.7519.85 ± 6.72aValues with different superscripts are significantly different (P<0.05); Total FSH highly significant (P<0.001).17.57 ± 7.2912.78 ± 5.8382 (82.8)69 (69.7)Twice929.75 ± 0.6622.76 ± 8.37bValues with different superscripts are significantly different (P<0.05); Total FSH highly significant (P<0.001).19.60 ± 8.8413.51 ± 6.0773 (79.4)67 (72.8)∗Data are presented as Mean ± SDa,b Values with different superscripts are significantly different (P<0.05); Total FSH highly significant (P<0.001). Open table in a new tab ∗Data are presented as Mean ± SD CONCLUSION: There was a significant difference in FSH usage in the once daily compared to twice daily administration. A significant difference in pregnancy rates for once compared with twice a day gonadotropin dosing was not found in this study. Once daily gonadotropin injection dosing, adds to patient comfort and convenience without compromising treatment success.
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