המידע באדיבות מדיקונטקסט
Last Updated: 2001-07-13 17:30:38 EDT (Reuters Health)
WESTPORT, (Reuters Health) – For women seeking in vitro fertilization (IVF) who are at risk of ovarian hyperstimulation with standard stimulation with gonadotropins because of polycystic ovaries, a low-dose stimulation protocol using highly purified follicle-stimulating hormone (FSH-HP) "offers a safe and efficient treatment.".
"It is well documented in clinical practice that patients with polycystic ovary syndrome (PCOS) are at risk of producing a very high response under gonadotropin stimulation," Dr. Marc Germond and colleagues from CHUV, Lausanne, Switzerland, note in the June issue of the journal Fertility and Sterility. This excessive response is associated with poor quality oocytes that are more difficult to fertilize in vitro.
Dr. Germond's team tried the FSH-HP low-dose protocol in 61 IVF patients who had a very high ovarian response previously under the standard human menopausal gonadotropin (hMG) stimulation protocol.
None of the women had an excessive ovarian response with the low-dose FSH-HP protocol, according to the team, and while significantly fewer oocytes were retrieved, the quality of the oocytes was improved and led to a "strong improvement" in the fertilization rate compared with standard hMG stimulation.
The low-dose protocol also led to a "high" implantation rate of 21.8% to 23.1% for fresh and cryopreserved embryos. Cumulatively, 32 of the 61 patients had a successful , pregnancy outcome, for a 52.5% delivery rate.
Dr. Germond and colleagues write that they now use the protocol routinely in women with a history of excessive ovarian response to standard hMG stimulation. Use of the protocol as a first-choice regimen in patients with PCOS needs to be studied in a randomized trial, they caution.
Fertil Steril 2001;75:1131-1135.
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