Fertilization in Vitro
Conditions
Keywords
In vitro fertilization, Poor ovarian responder, Luteal ovarian stimulation, Antagonist protocol, Cumulus cells
Brief summary
The investigators attempted to compare the clinical outcomes and cumulus genes expression in poor ovarian responders undergoing luteal ovarian stimulation or follicular ovarian stimulation in in vitro fertilization cycles.
Detailed description
Multiple follicular wave theory proposed by Baerwald et al. implied that follicle recruitment may occur in the luteal phase of menstrual cycle. Therefore, luteal phase ovarian stimulation (LPOS) was considered as a potential feasible stimulation method during in vitro fertilization (IVF) cycle. In the beginning, in order to avoid delaying cancer treatment, LPOS was applied for fertility preservation of cancer patients, showing no difference in numbers of oocyte retrieved, mature oocytes and fertilization rate between luteal or follicular phase stimulation. In the recent, LPOS was used for infertility women, suggesting that LPOS owned quite good IVF outcomes. In previous studies, premature luteinizing hormone (LH) surge, a major reason worsening ovarian quality in poor ovarian responders (PORs), was seldom found in LPOS. High progesterone in luteal phase may aid in suppressing premature LH surge. An updated research claimed that numbers of oocyte retrieved, mature oocytes and fertilized oocytes in LPOS significantly increased when compared to follicular ovarian stimulation. Therefore, the investigators presumed that LPOS was a more effective method than follicular stimulation in PORs.
Interventions
OTHERluteal ovarian stimulation
In the in vitro fertilization cycle, controlled ovarian stimulation was started since the luteal phase.
OTHERfollicular ovarian stimulation
In the in vitro fertilization cycle, controlled ovarian stimulation was started since the follicular phase.
Sponsors
Kaohsiung Veterans General Hospital.
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
30 Years to 45 Years
Healthy volunteers
Yes
Inclusion criteria
* Poor ovarian responders (PORs) met the Bologna criteria, having at least two of the three following features: 1. advanced maternal age (≥ 40 years) or any other risk factor for POR, 2. a previous POR (≤ 3 oocytes with a conventional stimulation protocol), and 3. an abnormal ovarian reserve test. An abnormal ovarian reserve test was defined as antral follicle count (AFC) \< 5 or anti-Müllerian hormone (AMH) \< 1 ng/mL in this study. Moreover, two episodes of a previous POR after maximal stimulation alone would be sufficient to define a patient as a POR.
Exclusion criteria
* oophorectomy * exposure to cytotoxic or pelvic irradiation for malignancy * taking herbal drugs or other hormonal agents
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| oocytes and embryos | through study completion, an average of 1 year | retrieved oocytes in number, matured oocytes in number, fertilized oocytes in number, day 3 embryos in number, top-quality day 3 embryos in number |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| pregnancy rate | Pregnancy will be confirmed 4 weeks after embryo transfer. | Clinical pregnancy rate |
| genes expression | through study completion, an average of 1 year | cumulus cells genes expression |
Countries
Taiwan
Outcome results
None listed