A Prospective Randomized Trial Comparing Corifollitropin-α Late-start (day 4) Versus Standard Administration (day 2) in Expected Poor, Normal, and High Responders Undergoing Controlled Ovarian Stimulation for IVF

Overview

Journal J Assist Reprod Genet

Publisher Springer

Specialties Genetics
Reproductive Medicine

Date 2020 Mar 19

PMID 32185595

Citations 6

Authors

Alberto Revelli

Gianluca Gennarelli

Marta Sestero

Stefano Canosa

Andrea Carosso

Francesca Salvagno

Giulia Pittatore

Claudia Filippini

Chiara Benedetto

Affiliations

Soon will be listed here.

Abstract

Objective: To assess whether corifollitropin-α (CFα) late-start administration (day 4) and standard administration (day 2) can obtain similar oocyte yield and live birth rate.

Study Design: A randomized controlled trial.

Setting: University Hospital IVF Unit.

Patients: One hundred thirteen women undergoing IVF.

Interventions: Patients distributed in three subgroups (expected poor, normal, or high responders to FSH) were randomized into two treatment arms: (a) CFα late-start: CFα on day 4 + GnRH antagonist from day 8 + (when needed) recFSH from day 11; (b) CFα standard start: CFα on day 2 + GnRH antagonist from day 6 + (when needed) recFSH from day 9. IVF or ICSI was performed as indicated.

Results: Considering the whole study group, the late-start regimen obtained comparable oocyte yield (8.9 ± 5.6 vs. 8.8 ± 6.2; p = n.s.), cPR/started cycle (25% vs. 31.6%, p = n.s.), and cumulative live birth rate (LBR)/ovum pickup (OPU) (29.2% vs. 37.7%, p = n.s.) than the standard regimen. The outcome of the two regimens was comparable in the two subgroups of high and normal responders. Differently, in poor responders, oocyte yield was similar, but LBR/OPU was significantly lower with late-start CFα administration that caused 40% cancellation rate due to monofollicular response. ROC curves showed that the threshold AMH levels associated with cycle cancellation were 0.6 ng/ml for late-start regimen and 0.2 ng/ml for standard regimen.

Conclusion: CFα may be administered on either day 2 or day 4 to patients with expected high or normal response to FSH without compromising oocyte yield and/or live birth rate. Differently, late-start administration is not advisable for expected poor responders with AMH ≤ 0.6 ng/ml.

Trial Registration: NCT03816670.

Citing Articles

Clinical Outcomes in Patients Receiving Originator Follitropin Alfa and Follitropin Alfa Biosimilars in Real-world Clinical Practice: A Retrospective Study.

Patel N, Patel N, Patel M, Bhadarka H, Vyas K J Hum Reprod Sci. 2023; 16(2):148-155.

PMID: 37547084 PMC: 10404022. DOI: 10.4103/jhrs.jhrs_37_23.

Corifollitropin Alfa for Controlled Ovarian Stimulation in Assisted Reproductive Technologies: State of the Art.

de Carvalho B Rev Bras Ginecol Obstet. 2023; 45(1):43-48.

PMID: 36878252 PMC: 10021006. DOI: 10.1055/s-0042-1759631.

Effect of rLH Supplementation during Controlled Ovarian Stimulation for IVF: Evidence from a Retrospective Analysis of 1470 Poor/Suboptimal/Normal Responders Receiving Either rFSH plus rLH or rFSH Alone.

Canosa S, Carosso A, Mercaldo N, Ruffa A, Evangelista F, Bongioanni F J Clin Med. 2022; 11(6).

PMID: 35329901 PMC: 8954443. DOI: 10.3390/jcm11061575.

Corifollitropin alpha, clomiphene citrate and dydrogesterone without daily gonadotrophin: a new option of a friendly protocol for high-responder oocyte donors.

Melo A, Paula C, Santos T, Faria V, Rufato M, Barboza R JBRA Assist Reprod. 2021; 26(2):315-320.

PMID: 34672261 PMC: 9118961. DOI: 10.5935/1518-0557.20210082.

Effect of a Combination of Myo-Inositol, Alpha-Lipoic Acid, and Folic Acid on Oocyte Morphology and Embryo Morphokinetics in non-PCOS Overweight/Obese Patients Undergoing IVF: A Pilot, Prospective, Randomized Study.

Canosa S, Paschero C, Carosso A, Leoncini S, Mercaldo N, Gennarelli G J Clin Med. 2020; 9(9).

PMID: 32932604 PMC: 7564928. DOI: 10.3390/jcm9092949.

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