La stimulation de l’ovulation pour fécondation in vitro, en France : choix et résultats en fonction des protocoles et des gonadotrophines

Abstract

ObjectiveThe study objective was to analyze the ovarian stimulation practice in Assisted Reproductive Technology (ART) in France, to determine the factors influencing this practice and to analyze its impact on ART results. Materials and methodsThe study included all the cycles forms transmitted by the centres to the Agence de la biomédicine on FIVNAT forms and then transmitted from the agency to FIVNAT. All cycles with missing data or inconsistencies on ovarian stimulation and spontaneous cycles were excluded, leaving 18,601 cycles for analysis. The protocols were classified in four groups: agonists with short protocol, with long protocol, antagonists and cycles without GnRH agonists. Gonadotropins were regrouped in four groups: recombinant FSH, urinary FSH, HMG, and association of FSH (urinary or recombinant) and HMG. ResultsIf the basal protocol usually combines GnRH agonists with long protocol and recombinant FSH, the study shows that some patients characteristics, particularly women's age, ovulation status and previous failures have a large influence on other choices for protocol (short protocol, antagonists) and gonadotropins. Concerning the impact on ART outcome, if short protocols remain associated to the worse results, there was little difference between long protocol and antagonists and according to the gonadotropin choice. Discussion and conclusionThis study allows to know better on ovarian stimulation practice in ART in France.