Verification of the Utility of the Gonadotropin Starting Dose Calculator in Progestin-primed Ovarian Stimulation: A Comparison of Empirical and Calculated Controlled Ovarian Stimulation

Overview

Journal Reprod Med Biol

Specialty Biology

Date 2024 Jun 3

PMID 38827517

Authors

Masato Kobanawa

Jouji Yoshida

Affiliations

Soon will be listed here.

Abstract

Purpose: To validate the effectiveness of a gonadotropin starting dose calculator for progestin-primed ovarian stimulation (PPOS), we conducted a study comparing the outcomes of oocyte retrieval between a group assigned gonadotropin doses via the calculator and a control group, where doses were determined by the clinician's empirical judgment.

Methods: Patients underwent controlled ovarian stimulation (COS) using the PPOS method, followed by oocyte retrieval. We assessed and compared the results of COS and oocyte retrieval in both groups. Additionally, we examined the concordance rate between the number of oocytes actually retrieved and the target number of oocytes in each group.

Results: The calculated group demonstrated a significantly higher number of preovulation follicles and a higher ovarian sensitivity index than the control group. Furthermore, the discrepancy between the target and actual number of oocytes retrieved was notably smaller in the calculated group. The concordance rate between the target and actual number of oocytes was significantly greater in the calculated group.

Conclusions: The gonadotropin starting dose calculator proved to be effective within the PPOS protocol, offering a reliable method for predicting the approximate number of oocytes to be retrieved, irrespective of the COS protocol employed.

Citing Articles

Verification of the utility of the gonadotropin starting dose calculator in progestin-primed ovarian stimulation: A comparison of empirical and calculated controlled ovarian stimulation.

Kobanawa M, Yoshida J Reprod Med Biol. 2024; 23(1):e12586.

PMID: 38827517 PMC: 11140174. DOI: 10.1002/rmb2.12586.

References

Li D, Hu Z, Chen Q, Chai W, Cai R, Kuang Y . Neonatal outcomes and congenital malformations in children born after progestin-primed ovarian stimulation protocol. Front Endocrinol (Lausanne). 2022; 13:965863. PMC: 9681814. DOI: 10.3389/fendo.2022.965863. View

Ledger W, Wiebinga C, Anderson P, Irwin D, Holman A, Lloyd A . Costs and outcomes associated with IVF using recombinant FSH. Reprod Biomed Online. 2009; 19(3):337-42. DOI: 10.1016/s1472-6483(10)60167-8. View

Magnusson A, Nilsson L, Olerod G, Thurin-Kjellberg A, Bergh C . The addition of anti-Müllerian hormone in an algorithm for individualized hormone dosage did not improve the prediction of ovarian response-a randomized, controlled trial. Hum Reprod. 2017; 32(4):811-819. DOI: 10.1093/humrep/dex012. View

Droesch K, Muasher S, Brzyski R, Jones G, Simonetti S, Liu H . Value of suppression with a gonadotropin-releasing hormone agonist prior to gonadotropin stimulation for in vitro fertilization. Fertil Steril. 1989; 51(2):292-7. DOI: 10.1016/s0015-0282(16)60493-4. View

Alport B, Case A, Lim H, Baerwald A . Does the Ovarian Stimulation Phase Length Predict In vitro Fertilization Outcomes?. Int J Fertil Steril. 2014; 5(3):134-41. PMC: 4122827. View

Lekamge D, Lane M, Gilchrist R, Tremellen K . Increased gonadotrophin stimulation does not improve IVF outcomes in patients with predicted poor ovarian reserve. J Assist Reprod Genet. 2008; 25(11-12):515-21. PMC: 2593769. DOI: 10.1007/s10815-008-9266-6. View

La Marca A, Sunkara S . Individualization of controlled ovarian stimulation in IVF using ovarian reserve markers: from theory to practice. Hum Reprod Update. 2013; 20(1):124-40. DOI: 10.1093/humupd/dmt037. View

Howles C, Saunders H, Alam V, Engrand P . Predictive factors and a corresponding treatment algorithm for controlled ovarian stimulation in patients treated with recombinant human follicle stimulating hormone (follitropin alfa) during assisted reproduction technology (ART) procedures. An.... Curr Med Res Opin. 2006; 22(5):907-18. DOI: 10.1185/030079906X104678. View

Genro V, Grynberg M, Scheffer J, Roux I, Frydman R, Fanchin R . Serum anti-Müllerian hormone levels are negatively related to Follicular Output RaTe (FORT) in normo-cycling women undergoing controlled ovarian hyperstimulation. Hum Reprod. 2010; 26(3):671-7. DOI: 10.1093/humrep/deq361. View

10.

Schipper I, Hop W, Fauser B . The follicle-stimulating hormone (FSH) threshold/window concept examined by different interventions with exogenous FSH during the follicular phase of the normal menstrual cycle: duration, rather than magnitude, of FSH increase affects follicle.... J Clin Endocrinol Metab. 1998; 83(4):1292-8. DOI: 10.1210/jcem.83.4.4710. View

11.

La Marca A, Sighinolfi G, Radi D, Argento C, Baraldi E, Artenisio A . Anti-Mullerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART). Hum Reprod Update. 2009; 16(2):113-30. DOI: 10.1093/humupd/dmp036. View

12.

Sterrenburg M, Veltman-Verhulst S, Eijkemans M, Hughes E, Macklon N, Broekmans F . Clinical outcomes in relation to the daily dose of recombinant follicle-stimulating hormone for ovarian stimulation in in vitro fertilization in presumed normal responders younger than 39 years: a meta-analysis. Hum Reprod Update. 2010; 17(2):184-96. DOI: 10.1093/humupd/dmq041. View

13.

Ata B, Capuzzo M, Turkgeldi E, Yildiz S, La Marca A . Progestins for pituitary suppression during ovarian stimulation for ART: a comprehensive and systematic review including meta-analyses. Hum Reprod Update. 2020; 27(1):48-66. DOI: 10.1093/humupd/dmaa040. View

14.

van Loenen A, Huirne J, Schats R, Hompes P, Lambalk C . GnRH agonists, antagonists, and assisted conception. Semin Reprod Med. 2003; 20(4):349-64. DOI: 10.1055/s-2002-36713. View

15.

van Tilborg T, Torrance H, Oudshoorn S, Eijkemans M, Koks C, Verhoeve H . Individualized versus standard FSH dosing in women starting IVF/ICSI: an RCT. Part 1: The predicted poor responder. Hum Reprod. 2017; 32(12):2496-2505. DOI: 10.1093/humrep/dex318. View

16.

Yadav V, Malhotra N, Mahey R, Singh N, Kriplani A . Ovarian Sensitivity Index (OSI): Validating the Use of a Marker for Ovarian Responsiveness in IVF. J Reprod Infertil. 2019; 20(2):83-88. PMC: 6486569. View

17.

Popovic-Todorovic B, Loft A, Lindhard A, Bangsboll S, Andersson A, Nyboe Andersen A . A prospective study of predictive factors of ovarian response in 'standard' IVF/ICSI patients treated with recombinant FSH. A suggestion for a recombinant FSH dosage normogram. Hum Reprod. 2003; 18(4):781-7. DOI: 10.1093/humrep/deg181. View

18.

Lan V, Linh N, Tuong H, Wong P, Howles C . Anti-Müllerian hormone versus antral follicle count for defining the starting dose of FSH. Reprod Biomed Online. 2013; 27(4):390-9. DOI: 10.1016/j.rbmo.2013.07.008. View

19.

Palomba S, Costanzi F, Nelson S, Caserta D, Humaidan P . Interventions to prevent or reduce the incidence and severity of ovarian hyperstimulation syndrome: a systematic umbrella review of the best clinical evidence. Reprod Biol Endocrinol. 2023; 21(1):67. PMC: 10360244. DOI: 10.1186/s12958-023-01113-6. View

20.

Vlaisavljevic V, Apter S, Capalbo A, DAngelo A, Gianaroli L, Griesinger G . The Maribor consensus: report of an expert meeting on the development of performance indicators for clinical practice in ART. Hum Reprod Open. 2021; 2021(3):hoab022. PMC: 8254491. DOI: 10.1093/hropen/hoab022. View